在白内障手术后接受低剂量和高剂量葡萄糖皮质体治疗的儿童中,比较青光眼风险
Diana Chabané Schmidt1, Torben Martinussen2, Ameenat Lola Solebo3,4
1Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, Glostrup, Denmark.
Acta ophthalmologica
|August 12, 2024
概括
儿科白内障手术后低剂量葡萄糖皮质体治疗减少了长眼儿童的玻璃眼风险. 在这个人群中,高剂量的葡萄皮质类药物应少量使用,以最大限度地减少不良影响.
科学领域:
- 眼科医生 眼科 眼科
- 儿科手术 儿科手术
- 内分泌学 在内分泌学.
背景情况:
- 葡萄糖皮质类药物治疗对于儿童白内障手术后管理炎症至关重要.
- 然而,高剂量的葡萄糖皮质类药物可能会增加二次玻璃眼和下丘脑-垂体-上腺轴抑制的风险.
研究的目的:
- 在接受白内障手术的儿童中,比较高剂量和低剂量术后葡萄糖皮质体治疗方案之间的青光眼结局.
主要方法:
- 一项关于丹麦儿童 (10岁以下) 在2010-2021年间接受白内障手术的队列研究.
- 在低剂量和高剂量葡萄糖皮质体组之间比较持续的眼睛高血压或玻璃眼 (>3个月).
- 高剂量:连结膜下存储的德克萨米他/甲基普雷迪尼索隆加上局部的德克萨米他;低剂量:局部的德克萨米他,持续时间较短,频率较低.
主要成果:
- 分析了267名儿童 (388只眼睛);95人接受高剂量治疗,173人接受低剂量治疗.
- 生存分析表明,在低剂量组中,在轴长度≥18毫米的儿童中,青光眼的风险降低.
- 对于眼睛较短的儿童来说,在青光眼风险上没有显著的差异.
结论:
- 低剂量葡萄糖皮质体治疗与儿童白内障手术患者的青光眼风险降低有关,这些患者的轴长度≥18毫米.
- 在儿科白内障手术中,应尽量减少高剂量葡萄糖皮质激素的使用.
- 进一步的研究可能会探索基于眼睛参数的最佳葡萄糖皮质体剂量策略.
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