Ophthalmodynamometric estimation of cerebrospinal fluid pressure in pseudotumour cerebri

Abstract

A 17 year old woman suffering from chronic idiopathic uveitis in both eyes for 5 years had been treated topically, peribulbarly, and systemically with corticosteroids. As a steroid responder, she had developed secondary ocular hypertension. Steroid induced cataract in her right eye was operated on by phacoaspiration, transpupillary anterior vitrectomy, and posterior chamber lens implantation. To reduce the systemic side effects of steroid treatment, systemic cyclosporin A had been added to the treatment scheme since January 1998. In February 2000, she presented again with a severe uveitis with papilloedema and cystoid macular oedema. Despite intensive topical treatment with steroids given hourly, and systemic acetazolamide, visual acuity remained in the range 0.10?0.16. To avoid the side effects of systemic steroid treatment and to achieve high and longstanding concentrations of steroids in the eye, we injected 20 mg crystalline triamcinolone acetonide into the vitreous cavity of the right eye in July 2000 with topical anaesthesia.