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Br J Ophthalmol 2009;93:708-713 doi:10.1136/bjo.2008.154906
  • Review

Penetration of topical and subconjunctival corticosteroids into human aqueous humour and its therapeutic significance

  1. M A Awan1,
  2. P K Agarwal1,
  3. D G Watson2,
  4. Charles N J McGhee3,
  5. G N Dutton1,4,5
  1. 1
    Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK</addr-cpn>
  2. 2
    Strathclyde Institute of Pharmacy and Biomedical Sciences (SIPBS), University of Strathclyde, Glasgow, UK
  3. 3
    Department of Ophthalmology, University of Auckland, Auckland, New Zealand
  4. 4
    Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
  5. 5
    The Royal Hospital for Sick Children, Yorkhill, Glasgow, UK
  1. Mr M A Awan, Ophthalmology Department, Tennent Institute of Ophthalmology, Gartnavel General Hospital, 1053 Great Western Rd, Glasgow G12 0YN, UK; dramer_awan{at}yahoo.co.uk
  • Accepted 21 February 2009
  • Published Online First 16 March 2009

Abstract

Topical and subconjunctival corticosteroids are some of the most effective and compelling treatment options in ocular inflammatory diseases. A systematic review of literature indexed by Ovid MEDLINE & EMBASE was performed up to December 2008. There are few studies on their aqueous penetration in human subjects. This review article discusses the penetration of different ocular corticosteroids into human aqueous humour along with the therapeutic implications on management of ocular surface diseases, immune-related corneal diseases, anterior uveitis and postoperative anti-inflammatory use. In the context of the paucity of well-constructed, prospective clinical trials comparing the efficacy of different corticosteroids, it provides guiding principles for the use of topical corticosteroids. Dexamethasone alcohol 0.1% and prednisolone acetate 1% are potent corticosteroids, but the latter achieves the highest aqueous concentration within 2 h and maintains higher levels for 24 h. Subconjunctival corticosteroids provide very high concentrations in the aqueous which maintain higher concentrations for longer periods.

Footnotes

  • Competing interests: None.

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