No increase in IOP after 6 weeks of inhaled corticosteroid: study

Elevated intraocular pressure is the most important causal risk factor for glaucoma, and the administration of steroids may cause a harmful elevation in intraocular pressure, called a ‘steroid response’ in some people, Dr Edward Moss, MD, of the University of Toronto, said. Our study evaluated the safety of a very-commonly-prescribed inhaled steroid preparation, fluticasone propionate, in patients with glaucoma, who are at the highest risk of donstrating a steroid response, he said.To evaluate the effect of inhaled fluticasone propionate on IOP in patients with ocular hypertension or controlled open-angle glaucoma, Dr Moss and colleagues conducted a randomised, double-masked, controlled trial involving 20 patients aged 18 to 85 years.Patients were randomised to receive either fluticasone propionate 250¼g or placebo. Exclusion criteria included eyes with any prior incisional surgery, advanced glaucoma, or progressive/unstable disease in the previous six months.Patients were evaluated at baseline, as well as two, four and six weeks after starting the inhaler.The primary outcome was IOP, and secondary outcomes included visual acuity, anterior segment changes, patient-reported side effects, and compliance.Mean IOP was not statistically different between groups at any time: 14.7 ± 2.4 mm Hg in the steroid group versus 14.8 ± 3.8 mm Hg in the placebo group.There were no differences in secondary outcomes, including side effects, visual acuity, and lens changes. The preliminary results reveal no evidence of IOP elevation after six weeks of twice-daily fluticasone propionate in six patients with OHT and/or OAG,? the authors concluded.