Steroid-induced glaucoma in kidney transplant recipients: a prospective cross-sectional study

To determine the incidence of steroid induced glaucoma and treatment characteristics in kidney transplant patients in a tertiary level multispecialty institution.

In this prospective cross-sectional study, the patients who underwent kidney transplant were enrolled and underwent comprehensive ophthalmological evaluation including intraocular pressure (IOP) measurement with Goldmann Applanation tonometry, visual field examination with Humphrey Field Analyzer, and gonioscopy. Cases with IOP > 21 mm Hg, visual field defect, and optic disc cupping > 0.7 or asymmetry of 0.2 or more were labeled as glaucoma, whereas IOP > 21 mm Hg with a normal visual field was designated as ocular hypertension (OHT).

The mean age of patients was 39 ± 9 (range: 25-60) years. Out of 72 patients with kidney transplants, 7 (9.72%) patients were diagnosed with steroid-induced glaucoma, and 9 (12.5%) patients had ocular hypertension (OHT). Four (5.55%) patients underwent trabeculectomy to control IOP whereas 3 (4.16%) patients were controlled on anti-glaucoma medications. Best-corrected visual acuity < 6/9 was noted in 23 (31.94%) patients in at least one eye. The average follow-up was 30 months with interquartile range of 18-84 months. There was a significant association of cumulative dosage of steroid and development of cataract and OHT and glaucoma (P < 0.01).

Kidney transplant patients must be screened for glaucoma and other ocular abnormality and should be on routine ophthalmological follow-up due to the possibility of steroid induced glaucoma.