Risk of increased intraocular pressure and posterior subcapsular cataracts in asthmatic children on inhaled corticosteroids

ABSTRACT

With the increasing use of inhaled corticosteroids as first-line therapy in the treatment of asthma, the adverse effects of these preparations have become the topic of much research in recent years. While it is known that orally administered steroids can have metabolic, musculoskeletal dermatologic hematologic, and ophthalmologic effects [inhaled corticosteroids have minimal reported hematologic or musculoskeletal effects, but have some effects on metabolic processes such as calcium metabolism, it is less understood whether or not, and at what doses, inhaled corticosteroids will affect the eye. The objective of this study is to determine the risk of cataracts and increased intraocular pressure in chronic asthmatic patients on long term use of inhaled corticosteroids. This is a cross sectional study conducted on 30 asthmatic children [Group A] attending the outpatient asthma clinic in new children hospital - Faculty of medicine - Cairo university and 30 sex and age matched asthmatic children not receiving inhaled corticosteroids for asthma control [Group B]. All children were subjected to ophthalmologic examination by Snellen chart for visual acuity, slit lamp to detect posterior subcapsular cataracts and Handheld applanation tonometer to measure intraocular pressure in both eyes. Posterior subcapsular cataracts [PSC] was not detected in any case of both groups. Mean [IOP] in group A was 13.88 +/- 1.36 mmHg and in group B was 13.46 +/- 0.97 mmHg which revealed no Statistically significant difference of [IOP] between members of group A and group B. The use of ICS for population appears to have a negligible effect on the development of cataracts or increased intraocular pressure. However, whether the children chronically using ICS in excess of 5 years exhibit an increased predisposition for the development of cataracts or glaucoma at an older age is unknown. Additional prospective long-term studies and long-term monitoring of the extended use of ICS in children are warranted to better understand the potential long-term ocular side effects