Decreased incidence of glaucoma in children with asthma using inhaled corticosteroid: a cohort study

Area of Science:

• Ophthalmology
• Pediatrics
• Pulmonology

Background:

• Corticosteroids are effective asthma anti-inflammatories, but inhaled corticosteroid (ICS) effects on pediatric glaucoma are unclear.
• Previous research defined oral corticosteroid effects on intraocular pressure and lens opacity, necessitating investigation into ICS in children.

Purpose of the Study:

• To investigate the correlation between inhaled corticosteroid (ICS) use and glaucoma incidence in children diagnosed with asthma.
• To analyze a nationwide cohort to assess the safety of ICS in pediatric asthma patients concerning glaucoma development.

Main Methods:

• A nationwide cohort database from Taiwan's 2000 National Health Insurance Research Database was analyzed.
• 1,000,000 individuals were sampled, identifying 5,380 pediatric asthma patients (age ≤ 6 years at diagnosis).
• Cox's proportional hazard model was used to compare glaucoma risk between ICS users (1,232) and non-users (4,148) through December 2011.

Main Results:

• Inhaled corticosteroid (ICS) use was associated with a significantly lower risk of glaucoma (adjusted HR 0.52, 95% CI 0.28–0.96).
• The prevalence of glaucoma was 0.52-fold decreased in pediatric asthma patients using ICS.
• Cataract was identified as a comorbidity positively associated with glaucoma in this cohort (adjusted HR 8.22).

Conclusions:

• This study provides strong evidence that inhaled corticosteroids (ICS) are associated with a reduced incidence of glaucoma in children with asthma.
• Asthma patients with cataracts represent a high-risk group for glaucoma, warranting ophthalmological consultation.
• Further research and clinical consultation are recommended for high-risk pediatric asthma patients, particularly those with cataracts.