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The effect of betamethasone on intraocular pressure in nephrotic children
1Department of Pediatrics, Taipei Municipal Chung-Hsin Hospital, Taiwan, R.O.C.
Insights
Betamethasone treatment in nephrotic children significantly increased intraocular pressure (IOP), but symptoms resolved after discontinuing the drug. Regular eye exams are crucial for children on corticosteroid therapy.
Area of Science:
- Ophthalmology
- Pediatrics
- Endocrinology
Background:
- Nephrotic syndrome often necessitates long-term corticosteroid treatment.
- Corticosteroids, including betamethasone, are known to affect intraocular pressure (IOP).
- Children with nephrotic syndrome are at risk for steroid-induced ocular hypertension.
Purpose of the Study:
- To investigate the effect of betamethasone on intraocular pressure in nephrotic children.
- To compare IOP in nephrotic children undergoing treatment with normal controls.
- To assess the safety and reversibility of betamethasone-induced IOP changes.
Main Methods:
- Intraocular pressure (IOP) was measured using Goldmann's or Schiotz's methods.
- Study included 46 nephrotic children treated with betamethasone and 40 age-matched healthy controls.
- IOP measurements were taken before, during, and after betamethasone therapy.
Main Results:
- A statistically significant increase in mean IOP was observed in nephrotic children treated with full-dose betamethasone compared to controls and pre-treatment measurements.
- IOP remained significantly elevated at the end of treatment compared to two to four weeks after stopping betamethasone.
- Six patients experienced elevated IOP with headache or ocular pain, which resolved upon drug tapering or cessation.
Conclusions:
- Betamethasone therapy can cause a significant, yet reversible, increase in intraocular pressure in children with nephrotic syndrome.
- Corticosteroids are a causative factor in elevated IOP, necessitating careful monitoring.
- Regular ophthalmological examinations are highly recommended for pediatric patients receiving corticosteroid therapy.
Abstract:
Intraocular pressure (IOP) was measured by Goldmann's or Schiotz's method in 46 nephrotic children, who were treated with betamethasone, and in 40 age-matched normal controls at the Taipei Municipal Chung-Hsin Hospital, from July 1, 1987 to June 30, 1990. We found the difference in mean IOP between patients treated at the end of a full-dose course of betamethasone and normal controls or patients before treatment, was statistically significant. This difference was also found between the measurement of IOP at the end of a full-dose course of betamethasone, and after stopping betamethasone therapy two to four weeks later. Although six of all patients had high IOP and suffered from headache or ocular pain, clinically, at the end of full-dose betamethasone therapy, the symptoms disappeared quickly after tapering or stopping of the drug. Therefore, we believe it is very safe to treat the nephrotic syndrome with betamethasone. On the other hand, these observations indicate that corticosteroid is a causative factor in increasing IOP. Susceptibility to full-dose betamethasone is firmly recognized, and patients need to be monitored on an individual basis. Nephrotic syndrome is a chronic disease which often requires long-term corticosteroid treatment. Children with the syndrome are at risk of developing steroid-induced increasing IOP. Careful ophthalmological examination of nephrotic children, as well as other pediatric patients who received corticosteroid therapy, is highly recommended.