Sousa David Cordeiro, Leal Inês, Abegão Pinto Luis
Ophthalmology Department, Hospital de Santa Maria, Lisboa, Portugal.
Vision Sciences Study Center, CECV, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
BMJ Case Rep. 2018 Jun 27;2018:bcr-2018-225244. doi: 10.1136/bcr-2018-225244.
Steroid-induced ocular hypertension (SIOH) is a challenging entity in paediatric age, with many being refractory to medical therapy. Literature is scarce about surgical options in these cases. A 14-year-old girl with bilateral uveitis and macular oedema had received an intravitreal and subconjunctival triamcinolone injection in the right (OD) and left (OS) eye, respectively. While the steroid was effective in resolving the oedema, intraocular pressure (IOP) increased to about 40 mm Hg OD and 34 mm Hg OS, despite being under maximal IOP-lowering therapy. An initial conservative approach was preferred due to the young patient age and given that most cases of SIOH are transient. However, progressive structural changes were documented, and bilateral sequential minimally invasive glaucoma surgery (MIGS: XEN gel stent) was taken. With a follow-up of 6 months, the patient is drug-free with IOP around 14 mm Hg. This report discusses the role and efficacy of MIGS in a paediatric case of SIOH.
类固醇性青光眼（SIOH）在儿童期是一个具有挑战性的病症，许多病例对药物治疗无效。关于这些病例的手术选择的文献很少。一名14岁患有双侧葡萄膜炎和黄斑水肿的女孩，右眼（OD）和左眼（OS）分别接受了玻璃体内和结膜下曲安奈德注射。虽然类固醇在消除水肿方面有效，但尽管采用了最大程度的降低眼压治疗，眼压仍升至右眼约40 mmHg和左眼34 mmHg。由于患者年龄小且大多数SIOH病例是短暂性的，因此首选初始保守方法。然而，记录到了渐进性结构变化，于是进行了双侧序贯微创青光眼手术（MIGS：XEN凝胶支架）。随访6个月时，患者无需药物治疗，眼压约为14 mmHg。本报告讨论了MIGS在一例儿童SIOH病例中的作用和疗效。
