ABSTRACT
OBJECTIVE: Although systemic, topical, and periocular corticosteroid administration have long been associated with ocular side effects, there has been little evidence to suggest that long-term inhaled corticosteroids can cause ocular side effects. The aim of this study was to evaluate the effects of long term treatment inhaled fluticasone propionate spray usage the recommended dose on some ocular functions in pediatric patients with asthma. METHODS: The study group consisted of 266 prepubertal children with asthma who had used inhaled fluticasone propionate spray at 3-6 years intermittently. One hundred and sixty children who were newly diagnosed with asthma without any treatment made up the control group. Schirmer test results, central corneal thickness, visual acuity, intraocular pressure, cataract formation, keratometry and tear break-up time compared between study and control groups. RESULTS: The ages of the 266 study patients (150 male) were between 7 and 11 years. The average age (±SEM) was 8.2±1.7 years, and the mean (±SEM) a daily dose of 323 µg (range 250-450 µg) inhaled fluticasone propionate spray, with 865.2±215 g total steroid use during treatment. Eye functions including cataract formation, corneal ectasia, ocular hypertension or glaucoma, and dry eye were not observed in any of the patients in the study group and were not correlated with total steroid dosage (t=0.150, p=0.384). CONCLUSION: Our findings suggest that long-term intermittent treatment for 3-6 years with inhaled fluticasone propionate spray, as much as average 320 µg daily, in children with asthma seems to be safe for some eye functions.
Subject(s)
Androstadienes/adverse effects , Asthma/drug therapy , Bronchodilator Agents/adverse effects , Intraocular Pressure/drug effects , Tears/metabolism , Visual Acuity/drug effects , Case-Control Studies , Child , Female , Fluticasone , Humans , Male , Rhinitis, Allergic, Perennial/chemically induced , Tears/drug effects , Time FactorsABSTRACT
PURPOSE: This study aims to investigate the levels of aqueous vascular endothelial growth factor (VEGF) in diabetic patient groups in comparison to normal subjects, and to correlate elevated VEGF with the severity of diabetic retinopathy (DR). MATERIALS AND METHODS: Aqueous samples were obtained from 78 eyes of 74 patients undergoing intraocular surgery and they were examined by the enzyme-linked immunosorbent assay. Color photographs, optical coherence tomography scans, and fluorescein angiography were used to evaluate patients preoperatively. RESULTS: A strong statistical correlation was found to exist between the level of aqueous VEGF and the severity of DR ( P < 0.001), whereas, the VEGF levels in a control group and a diabetic group without DR were not significantly different ( P = 0.985). Aqueous VEGF levels were significantly elevated in patients with proliferative DR (PDR) as compared to the control group ( P < 0.001), to diabetic patients without retinopathy (NDR) ( P < 0.001), and to diabetic patients with nonproliferative DR (NPDR) ( P < 0.001). The aqueous VEGF levels were significantly higher in patients with active PDR than in those with quiescent PDR ( P = 0.001). On the other hand, a statistically insignificant ( P = 0.065) correlation was found between elevated aqueous VEGF and the presence of macular edema in the NPDR group. CONCLUSIONS: VEGF was elevated in the aqueous humor of patients with DR compared to that in normal eyes. The aqueous VEGF level had a strong correlation with the severity of retinopathy along with a statistically insignificant difference in macular edema.