Elevated intraocular pressure associated with steroid treatment for infantile spasms

Ronit Friling*, Dov Weinberger, Abraham Zeharia, Moshe Lusky, Marc Mimouni, Dan Gaaton, Moshe Snir

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Purpose: To evaluate the ocular changes and medical and surgical therapy after high-dose systemic steroid treatment in babies with infantile spasm and hypsarrhythmia. Design: Retrospective, noncomparative, interventional case series. Participants: In 5 of the 9 (55%) babies with infantile spasm exposed to systemic corticosteroid treatment, an increase in intraocular pressure (IOP) and optic disc cupping was observed. Intervention: Ophthalmic examination under mild sedation was conducted 3 to 4 weeks after initiation of systemic therapy. Antiglaucoma treatment was given to the patients found to have high IOPs and cup-to-disc ratio changes. Routine follow-up was continued until systemic therapy was completed. Main Outcome Measures: Controlled IOP with a decrease in cupping damage after antiglaucoma therapy. Results: Five patients required antiglaucoma treatment; one also underwent augmented trabeculectomy. Mean IOP decreased in this subgroup from 30.1 ± 9.5 mmHg to 15.4 ± 4.2 mmHg in the right eye (P = 0.043) and from 32.6 ± 7.4 mmHg to 15.2 ± 1.8 mmHg in the left eye (P = 0.043). Mean cup-to-disc ratio improved from 0.53 ± 0.2 to 0.37 ± 0.04 in the right eye (P = 0.06) and from 0.57 ± 0.12 to 0.35 ± 0.05 in the left eye (P = 0.042). Conclusions: The rapid onset of IOP and cup-to-disc ratio changes in patients with infantile spasm and hypsarrhythmia treated by high-dose corticosteroids necessitates early and intensive monitoring to prevent anatomic ocular damage and visual impairment in the future.

Original languageEnglish
Pages (from-to)831-834
Number of pages4
Issue number4
StatePublished - 1 Apr 2003


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