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Steroids Could Help Heal Some Corneal Ulcers: Study
The use of topical corticosteroids in a randomized controlled trial was found to be neither beneficial nor harmful in the overall patient population in the study. However, it helped patients who had more serious forms of bacterial corneal ulcers, according to UCSF researchers.
In a paper published this month in the Archives of Ophthalmology, one of the JAMA/Archives journals, researchers found significant vision improvement—one and a half to two lines of improvement on an eye chart—by using steroid therapy on patients with severe ulcers.
"We consider this finding very significant; it's a clinically meaningful difference," said the paper's co-author Nisha Acharya, MD, MS, associate professor and director of the Uveitis Service in the UCSF Department of Ophthalmology. Although secondary to the study's original purpose, Acharya said the results in severe cases were identified early on, so "we didn't start doing all of these analyses after the fact. It was of interest. So I think there is something there."
The use of topical corticosteroids is somewhat controversial within the ophthalmology community, with no specific evidence pointing one way or the other. Concerns include corneal perforation and worsening vision.
"It's important to note that in the worst ulcer group, not only do we not find a safety problem, we actually found that steroids resulted in a benefit in vision," Acharya said. "So I think that is really reassuring because those were the people with whom we were most scared to use steroids."
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