ABSTRACT
PURPOSE: Exposure to corticosteroids is known to be associated with an increased risk of cataract and glaucoma. This study was undertaken to determine the prevalence of steroid-induced cataract and glaucoma in patients with chronic obstructive pulmonary disease (COPD) and to assess a dose-response relationship between them. DESIGN: This was a prospective observational study. METHODS: We identified all COPD patients aged 50 years or older, with minimum steroid exposure of 4 months and on inhaled corticosteroids from March 2014 to March 2015. Average daily dose of inhaled corticosteroids was defined as low (1-250 µg), medium (251-500 µg), and high (501-1000 µg) using fluticasone propionate equivalents. RESULTS: We screened 405 COPD patients, of which 48 were dropouts. We identified 58 cataract and 14 glaucoma patients with a prevalence of 16.24% and 3.92%, respectively. We also observed a dose-response relationship with the highest prevalence of cataract (39.6%) and glaucoma (42.8%) at daily doses of 501-1000 µg fluticasone propionate equivalents. CONCLUSIONS: It is evident that higher doses and longer duration of inhaled corticosteroid in COPD patients are associated with a higher prevalence of cataract and glaucoma.
