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Risk of cataracts and glaucoma with inhaled steroid use in children
Sailaja Nootheti1, Leonard Bielory
1University of Medicine and Dentistry of New Jersey, 90 Bergen Street, Newark, NJ 07103, USA.
Insights
Inhaled corticosteroids, commonly used for asthma, may affect eye health, particularly intraocular pressure. More research is needed, especially in children, to understand these ocular effects and optimal dosing.
Area of Science:
- Ophthalmology
- Pulmonology
- Pharmacology
Background:
- Inhaled corticosteroids (ICS) are first-line asthma therapy.
- Systemic steroid side effects are known, but ocular effects of ICS are less understood.
- Limited research exists on ICS effects on children's eyes.
Purpose of the Study:
- To investigate the ocular adverse effects of inhaled corticosteroids.
- To determine if inhaled corticosteroids impact intraocular pressure.
- To assess dose-dependency and effects in pediatric populations.
Main Methods:
- Computerized literature search conducted.
- Searched for studies on oral and inhaled steroids (nasal/bronchial).
- Keywords included adverse effects, glaucoma, ocular effects, and increased ocular pressure.
Main Results:
- Inhaled corticosteroids have minimal hematologic or musculoskeletal effects.
- Some metabolic effects, like calcium metabolism, are noted with ICS.
- Data on specific ocular effects, especially in children, remains limited.
Conclusions:
- The ocular safety profile of inhaled corticosteroids requires further investigation.
- Dose-response relationships for ocular effects are not well-established.
- More research, particularly in pediatric populations, is crucial to understand potential risks like glaucoma.
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 effect the eye. A computerized literature search was performed to search for literature pertaining to the specific use of oral or inhaled (nasal or bronchial) steroids, adverse effects, side effects, long-term use, chronic use, glaucoma, ocular effects, and increased ocular pressure. The search focused on the effects of inhaled corticosteroids in both adults and children, but contained an emphasis on children; studies pertaining to the effects in children, however, are limited.
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