Fel Audrey, Aslangul Elisabeth, Le Jeunne Claire
Assistance Publique-Hôpitaux de Paris, Hôtel-Dieu, université Paris Descartes, service de médecine interne, 75004 Paris, France.
Presse Med. 2012 Apr;41(4):414-21. doi: 10.1016/j.lpm.2012.02.001. Epub 2012 Feb 28.
Most common side effects of systemic corticosteroids are posterior subcapsular cataract and glaucoma. There is no way to prevent corticosteroid-induced cataract. The risk of these complications varies (cataract 11 to 15%; glaucoma 12.8%), and it depends on the dose, duration of administration and terrain. The discontinuation of corticosteroid therapy is required in cases of uncontrolled glaucoma by hypotonic treatment. Long-term topical or general steroids prescription has to be done after an ophthalmological examination. Indications of ophthalmic general corticosteroids are acute orbital and ocular inflammations. affecting the middle and posterior segments of the eye, or sclera when topical treatment is ineffective. When administered topically, only 5% of the delivered dose is absorbed by the anterior segment, distribution is almost zero in the middle and posterior segments of the eye.
全身用皮质类固醇最常见的副作用是后囊下白内障和青光眼。没有办法预防皮质类固醇诱发的白内障。这些并发症的风险各不相同（白内障为11%至15%；青光眼为12.8%），这取决于剂量、给药持续时间和个体情况。对于经低渗治疗眼压仍无法控制的青光眼患者，需要停用皮质类固醇治疗。长期局部或全身使用类固醇药物必须在眼科检查后进行。眼科全身用皮质类固醇的适应证为急性眼眶和眼部炎症，影响眼的中后段，或局部治疗无效时累及巩膜。局部给药时，仅5%的给药剂量被眼前段吸收，在眼的中后段分布几乎为零。
