Behbehani Abdulmutalib H, Owayed Abdulla F, Hijazi Zeinat M, Eslah Esmail A, Al-Jazzaf Adel M
Department of Surgery, Ophthalmology Division, Faculty of Medicine, Kuwait University, Alsafat, Kuwait.
J Pediatr Ophthalmol Strabismus. 2005 Jan-Feb;42(1):23-7. doi: 10.3928/01913913-20050101-03.
To ascertain the incidence of posterior subcapsular cataract and ocular hypertension in a cohort of children < or = 12 years on inhaled steroid therapy.
In this prospective study, a detailed history regarding corticosteroid therapy was obtained for children attending an asthma clinic. The presence and type of lens changes (cataract) was recorded and intraocular pressure (IOP) was measured. The children underwent another eye examination 2 years later.
Ninety-five patients were enrolled in the study. Mean patient age was 7 +/- 3 years, and mean duration of inhaled steroid therapy was 2 +/- 1 years. Thirty-six percent of patients received inhaled steroids exclusively, 61% received inhaled steroids with a short course of oral steroids, and 3% received inhaled steroids with a long course of oral steroids. Only 3 (3%) patients had cortical changes that were not visually significant, and none had posterior subcapsular or nuclear cataract. There was no significant differences between children with cataract and those without cataract with respect to age; duration of asthma; and duration, average daily dose, and cumulative dose of inhaled steroids. IOP ranged from 11 to 20 mm Hg (mean, 16 +/- 3 mm Hg). None of the children had ocular hypertension or glaucoma. Ninety patients underwent eye examination 2 years later; none was found to develop posterior subcapsular cataract or increased IOP.
This study indicates the use of inhaled steroids in children with asthma is probably safe as far as not inducing posterior subcapsular cataract or ocular hypertension.
确定12岁及以下接受吸入性类固醇治疗的儿童队列中后囊下白内障和高眼压的发生率。
在这项前瞻性研究中，我们获取了哮喘门诊患儿的详细皮质类固醇治疗史。记录晶状体变化（白内障）的存在情况和类型，并测量眼压（IOP）。这些儿童在2年后接受了另一次眼部检查。
95名患者纳入本研究。患者平均年龄为7±3岁，吸入性类固醇治疗的平均疗程为2±1年。36%的患者仅接受吸入性类固醇治疗，61%的患者接受吸入性类固醇治疗并短期口服类固醇，3%的患者接受吸入性类固醇治疗并长期口服类固醇。只有3名（3%）患者有皮质变化，但在视觉上不显著，且无人患有后囊下或核性白内障。有白内障和无白内障的儿童在年龄、哮喘病程、吸入性类固醇的疗程、平均每日剂量和累积剂量方面无显著差异。眼压范围为11至20 mmHg（平均，16±3 mmHg）。所有儿童均无高眼压或青光眼。90名患者在2年后接受了眼部检查；未发现有人发生后囊下白内障或眼压升高。
本研究表明，对于哮喘儿童，使用吸入性类固醇可能不会诱发后囊下白内障或高眼压，因此可能是安全的。
