Kaur Savleen, Dhiman Indu, Kaushik Sushmita, Raj Srishti, Pandav Surinder S
Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
J Glaucoma. 2016 Apr;25(4):343-7. doi: 10.1097/IJG.0000000000000209.
The aim of our study was to analyze the epidemiological profile and outcome of steroid-induced ocular hypertension in children below 12 years of age in a tertiary eye center.
Hospital records of patients attending the pediatric glaucoma clinic from July 2005 to December 2012 at our center were retrospectively reviewed. Steroid-induced ocular hypertension was defined as intraocular pressures (IOP)>21 mm Hg (or an increase of>6 mm from baseline) with or without associated glaucomatous optic neuropathy after intake of steroids in any form. Demographic data, management details and IOP, anterior segment, and posterior segment findings were recorded. The main outcome measure was the control of IOP after treatment.
Of the acquired pediatric glaucoma patients, 24% were steroid-induced ocular hypertensives (36 of 150 patients) (mean age group 9.2 ± 2.4 y). We studied 57 eyes of 36 patients that had an IOP>21 mm Hg after steroid intake. Of the 36 patients, 22 had bilateral steroid hypertensive response. Of all the patients, 15 (41.6%) received steroids because of vernal conjunctivitis, 16 (22 eyes) could be managed by withdrawing steroids only, 13 (25 eyes) were controlled by medical therapy, and 7 (10 eyes) needed surgery. Favorable outcome (defined as<21 mm of Hg with/without topical antiglaucoma medications) was achieved in 80.5% at the last follow-up (mean 17.4 ± 23.47 mo; range 4 mo to 8 y).
Our paper emphasizes on the ocular hypertensive side effects of steroids in children. There are many instances where one can avoid the use of steroids and consider nonsteroidal/anti-inflammatory alternatives. Withdrawal of steroids and antiglaucoma medicines are effective in controlling IOP in majority (80.5%).
本研究旨在分析一家三级眼科中心12岁以下儿童类固醇性高眼压的流行病学特征及转归。
回顾性分析2005年7月至2012年12月在本中心小儿青光眼门诊就诊患者的医院记录。类固醇性高眼压定义为在使用任何形式的类固醇后，眼压（IOP）>21 mmHg（或较基线升高>6 mmHg），无论是否伴有青光眼性视神经病变。记录人口统计学数据、治疗细节以及眼压、眼前段和眼后段检查结果。主要观察指标为治疗后眼压的控制情况。
在获得性小儿青光眼患者中，24%为类固醇性高眼压患者（150例患者中的36例）（平均年龄组9.2±2.4岁）。我们研究了36例患者中57只在使用类固醇后眼压>21 mmHg的眼睛。在这36例患者中，22例有双侧类固醇性高血压反应。所有患者中，15例（41.6%）因春季角结膜炎接受类固醇治疗，16例（22只眼）仅通过停用类固醇即可控制，13例（25只眼）通过药物治疗得到控制，7例（10只眼）需要手术治疗。在最后一次随访时（平均17.4±23.47个月；范围4个月至8年），80.5%的患者获得了良好的转归（定义为眼压<21 mmHg，无论是否使用局部抗青光眼药物）。
我们的论文强调了类固醇对儿童的高眼压副作用。在许多情况下，可以避免使用类固醇，考虑使用非甾体/抗炎替代药物。停用类固醇和抗青光眼药物对大多数患者（80.5%）控制眼压有效。
