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Combined subconjunctival injection of dexamethasone for the management of acute primary angle closure: a randomised controlled trial
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  • Published on: 23 January 2020
    Combined subconjunctival injection of dexamethasone for the management of acute primary angle closure: a randomised controlled trial
    • Wenbin Huang, Doctor Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People’s Republic of Chin
    • Other Contributors:
      • Xiulan Zhang, Doctor

    The authors would like to thank Dr. MAYURI BORGOHAIN et al. for their interest on our study ‘Combined subconjunctival injection of dexamethasone for the management of acute primary angle closure: a randomised controlled trial’, and appreciate their insightful comments.
    First, in this study, for “Combined Subconjunctival Injection of Dexamethasone”, we means combination subconjunctival injection of Dexamethasone with anti-glaucoma drug (such as topical pilocarpine, beta-blocker, brinzolamide, and alpha-2 agonists).
    Second, for better investigating the effectiveness of injection of dexamethasone, the control group was designed to not subjected to any topical anti-inflammatory drug. Moreover, Patients that were excluded with a usage of topical anti-inflammatory drugs (including NASIDs and steroids), which was mentioned in the method part.
    Third, the range of intraocular pressure (IOP) in those 42 eyes was 27-60 mmHg.
    Fourth, to study the window period from onset of acute attack for maximum efficacy of subconjunctival dexamethasone injection, we performed correlation analysis between the duration before recruitment with the decrease of IOP (IOPbaseline – IOP24h)，and found that the decrease of IOP was corelated with the duration before recruitment (r = -0.481, p = 0.002). Moreover, about one half of patients that the duration less than 5 days had more efficacy of subconjunctival dexamethasone injection.

    Conflict of Interest:
    None declared.
  • Published on: 23 January 2020
    Combined subconjunctival injection of dexamethasone for the management of acute primary angle closure: a randomised controlled trial
    • MAYURI BORGOHAIN, Glaucoma Fellow Sri sankaradeva Nethralaya
    • Other Contributors:
      • PRAFULLA SARMA, Glaucoma Specialist
      • Harsha Bhattacharjee, President
      • SHAHINUR SANGMA, Glaucoma specialist
      • CHENGCHIRA A SANGMA, Glaucoma specialist
      • Palak J Chirania, DNB trainee

    To,
    The editor
    We would like to congratulate Huang et al. for their study ‘Combined subconjunctival injection of dexamethasone for the management of acute primary angle closure: a randomised controlled trial’.1 However, we have few queries and seek your kind attention.
    First, as mentioned in this article, a previous study in dogs showed combination of topical anti-inflammatory eye drops was beneficial during treatment.2They had conducted this present study as there was no data on humans regarding a randomised controlled trial that demonstrates the effectiveness of anti-inflammatory drugs for the treatment of human eyes suffering from acute primary angle closure (APAC). However, as the title suggested combination of subconjunctival dexamethasone injection, it implied combination of it with other anti-inflammatory drugs. However, the injection group was not subjected to any other anti-inflammatory drugs.
    Second, the authors’ previous study showed that the inflammatory response in the aqueous humor from APAC patient was evident and that multiple inflammatory factors were elevated significantly.3 Topical steroids help to reduce intraocular inflammation make the patient more comfortable.4 However; the control group was not subjected to any topical anti-inflammatory drug.
    Third, we are interested to know about the range of intraocular pressure (IOP) in those 42 eyes; the highest and lowest IOP recorded.
    Fourth, we are also interested to know r...

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    Conflict of Interest:
    None declared.