Abuekteish F, Kirkpatrick J N, Russell G
Department of Medical Paediatrics, Royal Aberdeen Children's Hospital, Foresterhill, UK.
Thorax. 1995 Jun;50(6):674-6. doi: 10.1136/thx.50.6.674.
Although posterior subcapsular cataract complicates both systemic and topical corticosteroid therapy, the literature on the effects of inhaled corticosteroids is conflicting.
One hundred and forty children and young adults on inhaled corticosteroids were examined by slit lamp ophthalmoscopy after pupillary dilatation; 103 had received one or more short courses (< or = 7 days) of oral corticosteroids in the management of acute asthmatic attacks and four had also received one or more prolonged courses (> or = 4 weeks) of alternate day oral corticosteroid therapy.
Bilateral posterior subcapsular cataract was identified in one girl who had received several prolonged courses of oral corticosteroids, but was not identified in any other patient.
There is no evidence to support the contention that inhaled corticosteroid therapy on its own, or in association with short courses of oral corticosteroid therapy, might cause cataracts. Although children receiving long term systemic corticosteroid therapy should be screened for cataracts, this is unnecessary in children on inhaled corticosteroids alone.
尽管后囊下白内障会使全身和局部皮质类固醇治疗变得复杂，但关于吸入性皮质类固醇作用的文献存在矛盾之处。
对140名使用吸入性皮质类固醇的儿童和青年成人在瞳孔散大后进行裂隙灯眼底镜检查；103人在治疗急性哮喘发作时接受了一个或多个短期疗程（≤7天）的口服皮质类固醇治疗，4人还接受了一个或多个长期疗程（≥4周）的隔日口服皮质类固醇治疗。
在一名接受了多个长期疗程口服皮质类固醇治疗的女孩中发现了双侧后囊下白内障，但在其他患者中未发现。
没有证据支持以下观点，即单独使用吸入性皮质类固醇治疗或与短期口服皮质类固醇治疗联合使用可能会导致白内障。虽然接受长期全身皮质类固醇治疗的儿童应进行白内障筛查，但仅使用吸入性皮质类固醇的儿童无需进行此项检查。
