Chinese researchers recently found that subconjunctival dexamethasone injections for the management of acute primary angle closure eyes can significantly accelerate the relief of high intraocular pressure (IOP) and, therefore, improve the success rate of treatment. 

This randomized controlled trial recruited 42 patients with angle closure. Participants were separated into two arms: the injection group (21 patients) and the control group (21 patients). The injection group received subconjunctival 2.5mg dexamethasone in addition to the typical treatment regimen employed for both groups. Follow-ups were completed at zero, three, six, 12 and 24 hours after injection. The outcome measures included IOP and intraocular inflammation variables.

The team found that participant IOPs had significantly decreased in both groups since treatment. However, they note that 24 hours after the initial treatment, the IOPs of the injection group were significantly lower compared with controls. They add that the success rates of the injection group and the control group were 79.7% and 54.9% at 24 hours after treatment, respectively.

The researchers also discovered that, when looking at anterior chamber inflammation, the severity of conjunctival erythema, ciliary flush and pain in the injection group were also lower than that in the control group at 24 hours after treatment. They note that no statistical significance was found between the two groups regarding the anterior chamber cells, anterior chamber flare and photophobia.

Huang W, Li X, Gao K, et al. Combined subconjunctival injection of dexamethasone for the management of acute primary angle closure: a randomized controlled trial. Br J Ophthalmol. April 18, 2019. [Epub ahead of print].