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Risk of ocular hypertension in children treated with systemic glucocorticoid

Susanne Krag1, Dorte Larsen1, Birgitte Klug Albertsen2

  • 1Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark.

Acta Ophthalmologica
|February 25, 2021
PubMed

Insights

Systemic glucocorticoid treatment in children can cause ocular hypertension. Monitoring intraocular pressure is recommended, as younger children may face a higher risk of steroid-induced eye pressure increases.

Area of Science:

  • Pediatric Ophthalmology
  • Endocrinology
  • Pharmacology

Background:

  • Systemic glucocorticoids are widely used in pediatric care.
  • Potential side effects include ocular hypertension, a condition characterized by elevated intraocular pressure.
  • Understanding this risk is crucial for patient safety and monitoring.

Purpose of the Study:

  • To investigate the incidence and characteristics of steroid-induced ocular hypertension in children receiving systemic glucocorticoid therapy.
  • To identify potential risk factors associated with this adverse effect.

Main Methods:

  • A prospective cohort study involving children treated with high-dose systemic glucocorticoids (>0.5 mg/kg/day prednisolone equivalent) for over two weeks.
  • Intraocular pressure (IOP) was measured using an Icare tonometer.
  • Ocular hypertensive response defined as a net increase in IOP ≥6 mmHg or peak IOP ≥21 mmHg.

Main Results:

  • 56% of the 16 children studied developed a steroid-induced ocular hypertensive response.
  • 12% were classified as high responders with significant IOP elevations.
  • Younger children were more likely to be steroid responders (p=0.03).
  • No correlation found between IOP increase and steroid dosage or duration.

Conclusions:

  • Systemic glucocorticoid therapy in children poses a significant risk of elevated intraocular pressure.
  • Regular intraocular pressure screening is essential for children undergoing such treatments.
  • Age appears to be a significant factor, with younger children being more susceptible; further research into ethnic variations is warranted.
Abstract

Keywords:
childrenglaucomaocular hypertensionscreeningsteroid

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