Topical steroids used in the eye carry the risk of steroid-induced glaucoma. Which steroid is associated with the LEAST risk of IOP elevation while retaining anti-inflammatory efficacy?

• A Prednisolone acetate 1%
• B Dexamethasone 0.1%
• C Triamcinolone acetonide 4 mg/0.1 mL
• D Loteprednol etabonate 0.5% ✓

Explanation

Loteprednol etabonate is a retrometabolic steroid designed to be metabolically inactivated to inactive metabolites (delta-1 cortienic acid etabonate) after local action, minimising IOP elevation while maintaining anti-inflammatory effect. It has negligible IOP rise compared to prednisolone or dexamethasone, which have high IOP-raising potential. Triamcinolone (intravitreal) has significant and prolonged IOP elevation risk. Loteprednol is particularly useful in steroid-responders requiring long-term ocular anti-inflammatory therapy.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.