PubMed · 14277572
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I ABRAHAMS. 1965. PSORIASIS.. https://doi.org/10.1016/s0025-7125(16)33319-3
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PURPOSE: To ascertain the therapeutic effect of periocular corticosteroids in diabetic papillopathy. METHODS: Prospectively, five consecutive adult-onset diabetic patients with symptomatic diabetic papillopathy underwent visual fields and fluorescein angiography before and after superonasal subtenon injection of corticosteroids. RESULTS: The median duration of papillopathy was 2.5 weeks by ophthalmoscopy and 3 weeks by fluorescein angiography. The median recovery time of best-spectacle-corrected visual acuity was 2 weeks. Two patients developed sequential diabetic papillopathy, and both reported faster visual recovery and better subjective vision in treated eyes. In these two patients, the final best-spectacle-corrected visual acuity and visual evoked responses were comparable between the two eyes, while automated visual fields were less constricted in treated eyes. Complications included ocular hypertension, mild progression of cataract, and mild ptosis in one patient each. CONCLUSIONS: Periocular corticosteroids shortened the duration of diabetic papillopathy from a reported median of 5 months to 3 weeks in the present uncontrolled observational study, partly by their angiostatic and antioedema effects at the level of the anterior optic nerve. Intraocular pressure needs to be monitored in eyes receiving periocular corticosteroids.
BACKGROUND: Adults with chronic idiopathic thrombocytopenic purpura (ITP) in whom standard-dose corticosteroids and splenectomy have failed or who have contraindications to these therapies often require further treatment for life-threatening thrombocytopenia or bleeding. We studied whether danazol, an attenuated androgen, is useful in this setting. METHODS: To assess both clinical outcome and tolerance issues, 57 patients who had refractory chronic ITP (n = 27) or who had contraindications to splenectomy or corticosteroids or who refused these therapeutic options (n = 30) were studied. RESULTS: Thirty-eight patients experienced a partial or complete response to therapy (67%), among whom 27 (46%) remained in remission at a median (+/- SD) of 119 +/- 45 months. Treatment tolerance was acceptable, although severe adverse events were reported in 9 patients (16%). CONCLUSION: Our findings suggest that danazol therapy may be beneficial in the management of refractory chronic ITP or when there are contraindications to splenectomy or corticosteroids (or both).
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