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The short-term effects of intranasal steroids on intraocular pressure in pediatric population
Taylan Ozturk1, Ceren Durmaz Engin2, Seher Koksaldi3
1Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey. ataylan6@yahoo.com.
Insights
Intranasal mometasone furoate (INMF) may cause short-term intraocular pressure (IOP) increases in children with allergic rhinitis (AR). Ophthalmologic evaluation is recommended for children using intranasal steroids due to potential risks.
Area of Science:
- Ophthalmology
- Pediatrics
- Allergy & Immunology
Background:
- Allergic rhinitis (AR) is common in children.
- Intranasal steroids are a common treatment for AR.
- Potential ocular side effects of intranasal steroids, particularly in children, warrant investigation.
Purpose of the Study:
- To assess the short-term impact of intranasal mometasone furoate (INMF) on intraocular pressure (IOP) in pediatric patients diagnosed with allergic rhinitis (AR).
Main Methods:
- A cohort of children with AR prescribed INMF nasal spray was enrolled.
- Ophthalmologic examinations, including Tonopen XL IOP measurements, were conducted pre-treatment and at 1 and 6 weeks post-treatment.
- Exclusion criteria included ocular diseases other than refractive errors; statistical analysis was performed on demographic and ophthalmologic data.
Main Results:
- The study included 62 children (mean age 8.55 years).
- A statistically significant increase in IOP was observed at 1 and 6 weeks post-INMF initiation (p < 0.001).
- Elevated IOP was noted in children with a positive family history of glaucoma and those with optic disc cupping at the first week.
Conclusions:
- Children may be more susceptible to steroid-induced ocular hypertensive responses than adults.
- Ophthalmologic evaluation is advisable for all children undergoing treatment with intranasal steroids.
- Monitoring IOP is crucial in pediatric patients using INMF for allergic rhinitis.
Purpose:
To evaluate the effect of intranasal mometasone furoate (INMF) on short-term intraocular pressure (IOP) alterations in children with allergic rhinitis (AR).
Methods:
Children diagnosed with AR and to whom INMF nasal spray had been firstly prescribed were enrolled. Cases with any ocular diseases except for refractive errors were excluded. Complete ophthalmologic examinations including IOP measurements using Tonopen XL were performed before the treatment as well as at the first and sixth weeks of follow-up. Demographics and ophthalmologic findings were noted and statistically analyzed.
Results:
Study population consisted of 62 right eyes of 62 children with a mean age of 8.55 ± 3.14 years. Of them, 29 were female (46.8%) and 33 were male (53.2%). Dilated fundoscopy revealed an enlarged Cup/Disc ratio in 12 eyes (19.4%). Family history of glaucoma was positive in 13 cases (21.0%). Mean best corrected visual acuity was found as 0.05 ± 0.08 logMAR. Initial IOP was 17.1 ± 2.3 mmHg; whereas it was measured as 18.2 ± 2.0 mmHg and 17.3 ± 2.1 mmHg at the first and sixth weeks of follow-up, respectively (p < 0.001). Both at the first and sixth weeks of follow-up, significant IOP rise was present in children with a positive family history of glaucoma (p < 0.001 and p = 0.003, respectively). Besides, increased IOP was found in participants with cupping revealed on fundoscopy at the first week of follow-up (p = 0.044).
Conclusion:
Since children have greater risk for steroid-induced ocular hypertensive response than adults, ophthalmologic evaluation must be recommended in children receiving intranasal steroids.
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