Topical difluprednate for uveitis carries risk of IOP elevation

Elevations in intraocular pressure (IOP) occur commonly in uveitis patients who are receiving treatment with topical difluprednate, a study has found. This IOP elevation risk is pronounced among children and adult patients with concurrent systemic corticosteroids.

Researchers looked at the medical records of 54 patients (54 eyes) with noninfectious uveitis treated with topical difluprednate. They collected demographics, clinical characteristics, and data on the incidence of clinically important IOP elevation (defined as IOP ≥21 mm Hg and an increase of ≥10 mm Hg from baseline).

A total of 17 patients (31.5 percent) developed clinically important IOP elevation, which occurred at a mean of 7.4 weeks after treatment. Of note, 13.0 percent of the population developed IOP ≥30 mm Hg.

IOP elevation was independently associated with being a child (adjusted hazard ratio [aHR], 7.85, 95 percent confidence interval [CI], 1.48–41.56; p=0.02) and with concurrent use of systemic steroids (aHR, 5.31, 95 percent CI, 1.18–24.00; p=0.03).

Patients who used concurrent systemic corticosteroids developed clinically important IOP elevation earlier than those who were not receiving systemic corticosteroid (mean, 5.7 vs 10.4 weeks; p=0.05).

All patients showed favourable response to the cessation of difluprednate and/or use of topical antiglaucomatous agents. None of the study eyes required glaucoma surgery.