The occurrence timeline of steroid-induced ocular hypertension and cataract in children with systemic autoimmune diseases
The occurrence timeline of steroid-induced ocular hypertension and cataract in children with systemic autoimmune diseases
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DOI：
10.1007/s10792-022-02217-5
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发表时间：
2022-01-19
影响因子：
1.6
通讯作者：
Peng, Chunxia
中科院分区：
文献类型：
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作者：
Yan, Honggai;Tan, Xiaohua;Peng, Chunxia
目的激素性高眼压（SIOH）和白内障可导致视力下降。本研究评估了接受长期全身性皮质类固醇治疗的全身性自身免疫性疾病（SAD）儿童的SIOH和类固醇诱导的后囊下白内障（SI-PSC）发生的时间表。方法37例SAD患儿长期口服糖皮质激素治疗。每3个月记录一次眼内压（IOP）、SI-PSC发生率、视野和视乳头周围视网膜神经纤维层（pRNFL）厚度，至少持续6个月。结果37例患儿平均年龄11.0 ± 2.9岁，22例（59.5%）有SIOH，2例分别在18个月和3年随访时进展为青光眼，12例（32.4%）有SI-PSC。SIOH患者中SI-PSC发生率为45.5%（10/22），正常眼压患者中SI-PSC发生率为13.3%（2/15）。17名患者参加了一项纵向研究，随访期至少为18个月。SIOH的发生率从1个月开始为52.9%（9/17），逐渐上升至6个月时的70.6%（12/17），随后下降至35.3%（6/17）。SI-PSC在6个月时开始发病（17.6%，3/17），12个月时发病率增至35.3%（6/17），18个月时发病率增至41.2%（7/17）。SIOH儿童的pRNFL比健康对照组厚（p = 0.01）。结论SIOH和SI-PSC是儿童长期糖皮质激素治疗的常见并发症，发生时间分别在1个月和6个月。SIOH患者患白内障的可能性更高。
Purpose Steroid-induced ocular hypertension (SIOH) and cataract can result in visual loss. This study evaluated the timetable of SIOH and steroid-induced posterior subcapsular cataract (SI-PSC) occurrences in children with systemic autoimmune diseases (SAD) undergoing long-term systemic corticosteroid treatment. Methods Thirty-seven children with SAD treated with long-term oral corticosteroids were enrolled in this study. Intraocular pressure (IOP), SI-PSC occurrences, visual field and peripapillary retinal nerve fibre layer (pRNFL) thicknesses were recorded every 3 months for at least 6 months. Results Of the 37 children, with average age 11.0 +/- 2.9 years, 22 patients (59.5%) had SIOH, 2 progressed as glaucoma at the 18-month and 3-year follow-up, respectively, and 12 (32.4%) patients had SI-PSC. Among patients with SIOH, 45.5% (10/22) of them had SI-PSC occurrence, and among patients with normal IOP, 13.3% (2/15) of them had SI-PSC. Seventeen patients participated in a longitudinal study with a follow-up period of at least 18 months. The incidence of SIOH started at 1 month 52.9% (9/17) and gradually increased to 70.6% (12/17) at 6 months, then decreased to 35.3% (6/17). SI-PSC onset started at 6 months (17.6%, 3/17), and its occurrence increased to 35.3% (6/17) at 12 months and reached to 41.2% (7/17) at 18 months. The pRNFL was thicker in the children with SIOH than the healthy controls (p = 0.01). Conclusion SIOH and SI-PSC are common coexistent complications in children with long-term corticosteroids treatment, and the occurrence time is during the first month and 6 months, respectively. Patients with SIOH have a higher probability of cataract.