What is considered the strongest steroid in terms of raising intraocular pressure (IOP)?

Diflurprednate is recognized as the strongest steroid in terms of raising intraocular pressure (IOP) due to its high potency and efficacy in inflammation management. Corticosteroids have different profiles regarding their ability to elevate IOP, which is directly associated with their systemic absorption and local activity in the eye.

Diflurprednate, a fluorinated derivative of prednisolone, has been shown to have potent anti-inflammatory properties while also exhibiting a higher potential for IOP elevation compared to other corticosteroids. This increased potential for IOP elevation is particularly concerning for individuals with a predisposition to glaucoma or for those already diagnosed with the condition.

In contrast, hydrocortisone and triamcinolone, although they can also raise IOP, do not do so to the same extent as diflurprednate. Fluticasone, while a potent corticosteroid, is primarily used systemically and for respiratory conditions, and not as much for direct ocular inflammation, making it less relevant in this context of IOP elevation.

Overall, diflurprednate’s strong glucocorticoid activity along with its specific formulation contributes to the notable increase in IOP, making it the steroid of greatest concern in this regard.