ABSTRACT
The effectiveness of 3 alpha, 5 beta-tetrahydrocortisol (3 alpha, 5 beta-THF), a metabolite of cortisol, in lowering intraocular pressure (IOP) in rabbits made ocular hypertensive with glucocorticoids suggested its use in patients with Primary Open Angle Glaucoma (POAG). Patients with well-documented POAG were treated with a 1% suspension of 3 alpha, 5 beta-THF administered to one eye four times daily for up to six weeks. Eight out of nine patients experienced an appreciable decrease in IOP in the treated eye (average decrease 4.9 mm Hg). There was no conjunctival irritation, corneal pathology, visual field changes, alteration in liver or renal function tests or blood count during the treatment period. The present study demonstrates that 3 alpha, 5 beta-THF, a naturally occurring steroid metabolite, is effective in lowering IOP in patients with POAG. Antiglucocorticoids may represent a new therapeutic modality for the management of POAG.
Subject(s)
Glaucoma, Open-Angle/drug therapy , Tetrahydrocortisol/administration & dosage , Administration, Topical , Aged , Aged, 80 and over , Animals , Drug Administration Schedule , Female , Humans , Intraocular Pressure/drug effects , Male , Middle Aged , Ophthalmic Solutions , Rabbits , Tetrahydrocortisol/therapeutic useABSTRACT
The retinal toxicity of intravitreally injected steroids, fluorometholone and tetrahydrocortisol, was examined. The concentration of the steroids was 20 mg/ml, and 0.05 ml of each solution were injected into the rabbit vitreous cavity. An equal volume of saline solution was injected as a control. In addition to ophthalmoscopy, intraocular pressure was measured and electroretinography, light microscopy and electron microscopy were performed. The results showed no remarkable changes in all eyes. Fluorometholone and tetrahydrocortisol seem to have neither toxicity to the retina nor adverse effect of elevating intraocular pressure when intravitreally injected with this amount.
