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Steroid-Dependency in Posner-Schlossman Syndrome: A Suggested Topical 2% Ganciclovir and Gradual Decrement of Topical Steroid Combination Therapy from Shanghai PSS Study.
- Source :
-
Ocular immunology and inflammation [Ocul Immunol Inflamm] 2024 Jul; Vol. 32 (5), pp. 513-519. Date of Electronic Publication: 2023 Sep 13. - Publication Year :
- 2024
-
Abstract
- Purpose: This study focused on the prevalence, unique features, and required treatment of steroid-dependent Posner-Schlossman syndrome (SD-PSS), and analyzed the outcome of 2% Ganciclovir and gradual decrement steroid combination therapy in SD-PSS patients.<br />Methods: Retrospective comparative and interventional study. SD-PSS was defined as PSS patients with continuous steroid use for over 3 months and relapsed within 2 weeks after steroid withdrawal or tapered dosage. Totally 74 SD-PSS eyes were compared with 78 randomly chosen non-steroid dependent PSS eyes. SD-PSS patients who underwent 2% GCV and gradual decrement steroid therapy with at least two follow-ups ( n = 50) were analyzed for the treatment outcome.<br />Results: The prevalence of SD-PSS is 26.87% (97/361) in our PSS patients. SD-PSS patients demonstrated significantly younger onset age, longer disease course, higher intraocular pressure (IOP), and higher degree of iris depigmentation at the first visit. They required significantly more IOP-lowering medication and stronger steroid after the first visit. Our 2% GCV and gradual decrement steroid therapy helped 66% (33/50) SD-PSS patients with steroid withdrawal (median stable time: 13 weeks) and another 32% (16/50) SD-PSS managed to lower the dose or strength of topical steroid. Steroid-induced ocular hypertension happened in 5.26% (19/361) of the PSS patients.<br />Conclusion: Young onset age, high IOP, and high iris depigmentation level during acute stage are indicators of steroid dependency in PSS patients. SD-PSS patients require more medical surveillance. Two percent ganciclovir and gradual decrement steroid combination therapy help with steroid withdrawal and minimize steroid use.
- Subjects :
- Humans
Retrospective Studies
Male
Female
Middle Aged
Adult
China epidemiology
Ophthalmic Solutions
Intraocular Pressure drug effects
Intraocular Pressure physiology
Follow-Up Studies
Aged
Young Adult
Syndrome
Treatment Outcome
Visual Acuity
Administration, Topical
Ganciclovir administration & dosage
Glucocorticoids administration & dosage
Antiviral Agents administration & dosage
Antiviral Agents therapeutic use
Drug Therapy, Combination
Subjects
Details
- Language :
- English
- ISSN :
- 1744-5078
- Volume :
- 32
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Ocular immunology and inflammation
- Publication Type :
- Academic Journal
- Accession number :
- 37703505
- Full Text :
- https://doi.org/10.1080/09273948.2023.2251576