Gheissari Alaleh, Attarzadeh Hossein, Sharif Hoda, Pourhossein Meraj, Merrikhi Alireza
Associate Professor, Department of Pediatric Nephrology, Isfahan Kidney Diseases Research Center, Child Health Promotion Research Center, IUMS, Isfahan, Iran.
Int J Prev Med. 2011 Oct;2(4):264-8.
The aim of this study was to determine steroid dependent and independent ocular abnormalities in children with nephrotic syndrome (NS). Due to the relapsing nature of NS prolonged usage of corticosteroid puts the patients at the risk of ocular side effects of prednisolone. Since published data evaluating both steroid dependent and independent ophthalmic findings in children with NS is scarce, we evaluated ophthalmic findings in this group of patients according to the response to steroid.
The study population consisted of 35 patients with steroid-sensitive NS (SSNS) and 40 patients with steroid-resistant NS (SRNS). The patients who aged 2-18 years underwent ophthalmologic examination for steroid dependent and independent ocular abnormalities.
The median age of patients was 7.2 years (ranged 1.2-19 years). Forty-seven subjects were men and 28 were women. Patients with SRNS had significantly higher systolic and diastolic blood pressure than patients with SSNS (p < 0.05). Forty-five out of 75 patients (60%) had either steroid dependent or independent ophthalmic symptoms. Twenty percent of the patients had steroid dependent and 29% had steroid independent ocular abnormalities. Posterior subcapsular cataract and myopic astigmatism were the most common steroid dependent and independent ophthalmologic symptoms, respectively
Steroid independent eye involvements are not uncommon in NS children and should be considered especially in SRNS.
本研究旨在确定肾病综合征(NS)患儿中与类固醇相关及不相关的眼部异常情况。由于NS具有复发性,长期使用皮质类固醇会使患者面临泼尼松龙眼部副作用的风险。鉴于评估NS患儿中类固醇相关及不相关眼科检查结果的已发表数据较少,我们根据对类固醇的反应评估了该组患者的眼科检查结果。
研究人群包括35例类固醇敏感型NS(SSNS)患者和40例类固醇抵抗型NS(SRNS)患者。年龄在2至18岁的患者接受了针对与类固醇相关及不相关眼部异常的眼科检查。
患者的中位年龄为7.2岁(范围为1.2至19岁)。47名受试者为男性,28名受试者为女性。SRNS患者的收缩压和舒张压显著高于SSNS患者(p < 0.05)。75例患者中有45例(60%)存在与类固醇相关或不相关的眼科症状。20%的患者有与类固醇相关的症状,29%的患者有与类固醇不相关的眼部异常。后囊下白内障和近视散光分别是最常见的与类固醇相关及不相关的眼科症状。
在NS患儿中,与类固醇不相关的眼部受累并不少见,尤其在SRNS患儿中应予以考虑。