Intra ocular pressure in chronic users of oral glucocorticoids for rheumatoid arthritis

To evaluate intra ocular pressure (IOP) among rheumatoid arthritis (RA) patients who are chronic oral glucocorticoid users in low to moderate doses.

We have studied 125 subjects: 72 glucocorticoid users and 53 controls. The glucocorticoid users were RA patients treated with 5 to 40 mg/day of prednisone or equivalent. Controls were patients with osteoarthritis or with soft tissue rheumatic syndromes who had never used glucocorticoid orally or locally. The IOP was measured three times with Perkins tonometer in both eyes and the mean value was compared between groups. For statistical analysis we used the mean value between the IOP of both eyes.

Among RA glucocorticoid users the mean dose was 9.7 mg of prednisone daily during a mean period of 71.1 months. The IOP of glucocorticoid users was 5.8% higher than controls. This difference did not reach statistical significance. The rise in IOP was not affected by the duration of glucocorticoid treatment or by the dose. No RA patient using oral glucocorticoids was found to have abnormal IOP in this study.

Low dose glucocorticoids causes a small (5.8%), non significant increase in intraocular pressure.