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Background <p>This study aimed to investigate the association between plasma glucocorticoid receptor beta (GR β) levels and steroid-induced ocular hypertension in patients undergoing photorefractive keratectomy (PRK), along with selected autoimmune markers.</p> Methods <p>Patients who underwent PRK and used topical dexamethasone were evaluated on the 21st postoperative day. Demographic data, medical history, preoperative and postoperative refractive values, pachymetry, and intraocular pressure (IOP) were recorded. Corrected IOP values after laser treatment were documented. 30 patients with ocular hypertension (Group 1) and 20 with normal IOP (Group 2) were compared for plasma GR β levels and autoimmune markers including rheumatoid factor (RF), antinuclear antibody (ANA), and anti–double-stranded DNA (anti-dsDNA). Receiver operating characteristic (ROC) analysis and logistic regression analysis were performed to evaluate the discriminatory ability and association of GR β levels with postoperative ocular hypertension.</p> Results <p>In Group 1, pre-laser IOP increased from 14.34 ± 2.64 to 20.10 ± 5.03&#xa0;mm Hg post-laser. The mean cIOP, as per pachymetry post-laser, was 27.84 ± 4.5. Control group mean IOP values before and after laser were 13.42 ± 2.57 mmHg and 11.81 ± 2.52 mmHg, respectively. Corrected IOP, according to pachymetry post-laser, was 17.67 ± 3.14. Pre-laser IOP values did not differ significantly between the groups (<i>p</i> = 0.227), whereas both post-laser IOP and corrected post-laser IOP values were significantly higher in Group 1 compared to controls (<i>p</i> &lt; 0.001 both). RF values were normal in both groups, and ANA/Anti-dsDNA levels showed no significant differences (<i>p</i> = 0.229, <i>p</i> = 0.28 respectively). GR β levels differed significantly (<i>p</i> = 0.003), with means of 38.32 ± 8.53 in Group 1 and 66.23 ± 37.91 in Group 2. ROC analysis showed moderate discriminatory ability of GR β levels (AUC 0.76), with an optimal cut-off value of 41.39 pg/mL providing 80% sensitivity and 80% specificity. In univariable logistic regression analysis, higher GR β levels were associated with a lower likelihood of postoperative IOP elevation.</p> Conclusion <p>Plasma GR β levels may be associated with steroid-induced ocular hypertension in patients using topical steroids. However, these findings should be interpreted cautiously, and larger prospective studies are required to confirm their clinical relevance, establish clinically relevant cut-off values, and determine whether GR β has predictive value.</p>

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Evaluation of plasma glucocorticoid receptor beta levels and intraocular pressure elevation during topical dexamethasone use after photorefractive keratectomy

  • 期刊论文

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  • 发表日期：

    2026年7月31日

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  • Sıdıka Gerçeker Demircan,
  • Fatma Yülek

摘要

Background

This study aimed to investigate the association between plasma glucocorticoid receptor beta (GR β) levels and steroid-induced ocular hypertension in patients undergoing photorefractive keratectomy (PRK), along with selected autoimmune markers.

Methods

Patients who underwent PRK and used topical dexamethasone were evaluated on the 21st postoperative day. Demographic data, medical history, preoperative and postoperative refractive values, pachymetry, and intraocular pressure (IOP) were recorded. Corrected IOP values after laser treatment were documented. 30 patients with ocular hypertension (Group 1) and 20 with normal IOP (Group 2) were compared for plasma GR β levels and autoimmune markers including rheumatoid factor (RF), antinuclear antibody (ANA), and anti–double-stranded DNA (anti-dsDNA). Receiver operating characteristic (ROC) analysis and logistic regression analysis were performed to evaluate the discriminatory ability and association of GR β levels with postoperative ocular hypertension.

Results

In Group 1, pre-laser IOP increased from 14.34 ± 2.64 to 20.10 ± 5.03 mm Hg post-laser. The mean cIOP, as per pachymetry post-laser, was 27.84 ± 4.5. Control group mean IOP values before and after laser were 13.42 ± 2.57 mmHg and 11.81 ± 2.52 mmHg, respectively. Corrected IOP, according to pachymetry post-laser, was 17.67 ± 3.14. Pre-laser IOP values did not differ significantly between the groups (p = 0.227), whereas both post-laser IOP and corrected post-laser IOP values were significantly higher in Group 1 compared to controls (p < 0.001 both). RF values were normal in both groups, and ANA/Anti-dsDNA levels showed no significant differences (p = 0.229, p = 0.28 respectively). GR β levels differed significantly (p = 0.003), with means of 38.32 ± 8.53 in Group 1 and 66.23 ± 37.91 in Group 2. ROC analysis showed moderate discriminatory ability of GR β levels (AUC 0.76), with an optimal cut-off value of 41.39 pg/mL providing 80% sensitivity and 80% specificity. In univariable logistic regression analysis, higher GR β levels were associated with a lower likelihood of postoperative IOP elevation.

Conclusion

Plasma GR β levels may be associated with steroid-induced ocular hypertension in patients using topical steroids. However, these findings should be interpreted cautiously, and larger prospective studies are required to confirm their clinical relevance, establish clinically relevant cut-off values, and determine whether GR β has predictive value.