Prednisolone pill vs injection
Hello,
I have intermediate uveitis with recurring macular edemas. First my left eye was affected. I was treated with drops which worked well but the macular edema came back as I got off them. I then got an injection in the left eye which worked extremely well. My eye pressure went up quite a lot though (34) and we are managing it with Combigan and Travatan. My pressure is going down now.
Now my right eye has a macular edemas as well. Like the left eye, the drops worked well and I am tapering off now.
Unfortunately, the macular edema is already back (even just tapering off prednisolone drops makes it come back).
My ophthalmologist wants to put me on prednisolone pill rather than injection because my eye pressure goes up a lot on injections.
The thing is I am pretty sure the pills give high IOP as well. As per this article https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3481806/
How do I convince my doctor I want an injection instead of pills ? The side effects on systemic corticosteroids seems intense and frankly I would like to not have to deal with that. If systemic prednisolone raises IOP it would also raise it in my left eye which we do not want at this point as it is already high (27).
Thank you for your time and advice !
Edit : Or explain how my reasoning is wrong concering the pills vs injection. I am no doctor hahaha
Posted Jun 21, 2018, 9:37 PM UTC · edited
You should make sure you are seeing a retina specialist firstly. The reason your ophthalmologist wants you on oral steroids is because you seem to have bilateral macular edema. But you are right, the systemic side effects of Prednisone are numerous and the longer you are on it the worse they can be. Sometimes we use half dose Kenalog as a subTenon’s injection to mitigate the rise in intraocular pressure. If your insurance covers it, there is an intraocular steroid that is injected into the vitreous cavity called Ozurdex. It has less chance of causing glaucoma.
My ophtalmologist is a retina specialist :) Thank you for the info on the implants. I will definitively mention that !
Is it correct that oral prednisolone also raises IOP like drops and injections ?
Yes, oral prednisone can raise the IOP.
Thank you !