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Fluorinated corticosteroid toxicity in infants
American Journal of Ophthalmology
|August 1, 1977
Insights
A child died from Cushing's syndrome caused by topical fluorinated corticosteroids used after corneal surgery for sclerocornea. This highlights the risks of prolonged steroid use in pediatric ophthalmology.
Area of Science:
- Ophthalmology
- Endocrinology
- Pediatric Medicine
Background:
- Sclerocornea is a rare congenital condition requiring corneal grafts.
- Corticosteroids are frequently used post-keratoplasty to prevent graft rejection.
- Fluorinated corticosteroids offer potent anti-inflammatory effects but carry significant side effect risks.
Observation:
- An 11-month-old infant developed Cushing's syndrome.
- The syndrome was attributed to routine topical and periocular administration of fluorinated corticosteroids.
- These medications were prescribed following corneal homografts for sclerocornea.
Findings:
- The infant's Cushing's syndrome, a result of exogenous steroid exposure, led to fatal complications.
- This case underscores the potential for systemic absorption and adverse effects from topical ophthalmic steroids, even in infants.
Implications:
- Careful monitoring for systemic side effects is crucial in infants receiving long-term topical corticosteroids.
- Alternative immunosuppressive strategies may be considered to minimize steroid-related morbidity.
- This case emphasizes the need for judicious use and dose optimization of fluorinated corticosteroids in pediatric ophthalmology.
Abstract:
An 11-month-old girl died from complications of Cushing's syndrome. The latter was the result of routine topical and periocular dosages of fluorinated corticosteroids following corneal homografts for sclerocornea.