Methylprednisolone concentrations in the vitreous and the serum after pulse therapy

F. F. Behar-Cohen, S. Gauthier, A. Elaouni, P. Chapon, J. M. Parel, G. Renard, D. Chauvaud

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Purpose: Intravenous (IV) pulse of corticosteroids has been used to treat severe eye inflammation from different origins. Whether such large doses result in vitreous levels that differ either in magnitude or duration from more conventional corticotherapy remain unsolved issues. The authors therefore determined levels of methylprednisolone hemisuccinate and methylprednisolone in the vitreous and serum of patients at different times after a single IV perfusion of methylprednisolone hemisuccinate. Methods: Fifty patients scheduled for a first vitrectomy received an IV injection of 500 mg hemisuccinate methylprednisolone at different times before surgery (from 15-24 hours). Patients were divided into two groups: those with (n = 21) and without (n = 29) retinal detachment (RD). Pure vitreous samples were analyzed by high-pressure liquid chromatography. Results: Both the ester and the nonester methylprednisolone forms were sampled in the vitreous, showing a slower rate of hydrolysis compared to the serum. On average, the highest concentration of total methylprednisolone in the vitreous was found at 2.5 hours and rapidly decreased for the group of patients with RD. In the group of patients without RD, the highest concentration was reached at 6 hours and then slowly decreased. The antiinflammatory potency in the nondetached retina eyes was approximately 500 times more than in the physiologic vitreous, but despite the route of administration (IV or oral), only 1/10 of the corticosteroid serum concentration was measured in the vitreous. Conclusion: High concentration of methylprednisolone is achieved by IV pulse therapy without changing the kinetic of entry in the vitreous of nondetached retina eyes when compared to conventional oral corticotherapy. Hydrolysis occurs in the vitreous resulting in high rate of active form. Pulse therapy could be considered in cases of severe ocular inflammation involving the posterior segment of the eye.

Original languageEnglish (US)
Pages (from-to)48-53
Number of pages6
JournalRetina
Volume21
Issue number1
DOIs
StatePublished - Jan 1 2001

Keywords

  • Corticosteroids
  • Human
  • Inflammation
  • Pulse therapy
  • Vitreous

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems

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    Behar-Cohen, F. F., Gauthier, S., Elaouni, A., Chapon, P., Parel, J. M., Renard, G., & Chauvaud, D. (2001). Methylprednisolone concentrations in the vitreous and the serum after pulse therapy. Retina, 21(1), 48-53. https://doi.org/10.1097/00006982-200102000-00008