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Ocular complications in children with nephrotic syndrome on long term oral steroids

S Gaur1, M Joseph, S Nityanandam

  • 1Department of Pediatric Nephrology, St John's Medical College Hospital, Bangalore, India.

Indian Journal of Pediatrics
|February 22, 2014
PubMed

Insights

Steroid therapy for nephrotic syndrome can cause posterior subcapsular cataract (PSCC) and raised intraocular pressure (IOP) in children. Regular eye exams are crucial, as cumulative steroid dose and duration did not correlate with these ocular complications.

Area of Science:

  • Pediatric Nephrology
  • Ophthalmology
  • Pharmacology

Background:

  • Long-term steroid therapy is common for childhood nephrotic syndrome.
  • Steroids can lead to ocular complications like posterior subcapsular cataract (PSCC) and raised intraocular pressure (IOP).
  • The relationship between steroid dosage/duration and these complications in children requires further investigation.

Purpose of the Study:

  • To determine the prevalence of PSCC and raised IOP in children with nephrotic syndrome on long-term steroid treatment.
  • To assess the correlation between cumulative steroid dosage and duration of therapy with the development of PSCC and raised IOP.

Main Methods:

  • Cross-sectional study including children aged 4-18 years with nephrotic syndrome on steroids for at least six months.
  • Data collected from case records included demographic, clinical, and treatment details.
  • Comprehensive ocular examinations were performed to diagnose PSCC and measure IOP.

Main Results:

  • Out of 82 children analyzed, 26.8% had PSCC and 10.97% had raised IOP.
  • PSCC was significantly associated with older age at recruitment (p=0.009).
  • No significant correlation was found between cumulative steroid dose (p=0.58) or duration of therapy (p=0.73) and the presence of PSCC or raised IOP.

Conclusions:

  • A notable proportion of children with nephrotic syndrome on long-term steroids develop PSCC and raised IOP.
  • Neither cumulative steroid dose nor duration of therapy showed a significant association with these ocular issues.
  • Regular ophthalmic evaluations are essential for early detection and management of steroid-induced ocular complications in this pediatric population.
Abstract

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