Early and frequent development of ocular hypertension in children with nephrotic syndrome
Early and frequent development of ocular hypertension in children with nephrotic syndrome
复制标题
肾病综合征儿童早期且频繁发生高眼压症
DOI：
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发表时间：
2014
期刊：
影响因子：
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通讯作者：
M. Honda
中科院分区：
文献类型：
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作者：
Emi Kawaguchi;K. Ishikura;R. Hamada;Yoshinobu Nagaoka;Yoshihiko Morikawa;T. Sakai;Y. Hamasaki;H. Hataya;E. Noda;M. Miura;T. Ando;M. Honda
泼尼松龙是儿童肾病综合征的一线治疗药物，但其副作用严重。这些副作用之一是高眼压，可导致严重和永久性的视力障碍。然而，在这一儿童患者群体中，高眼压的确切患病率、严重程度和发展时间尚未得到充分探讨。方法回顾性队列研究，对首次使用强的松龙治疗的肾病综合征患儿进行分析。在强的松龙治疗开始前和治疗后1周和4周，用iCare®眼压仪筛查眼压，并用Goldmann眼压仪确认眼压。结果本研究共纳入26例肾病综合征患儿，其中8例（30.8%）患儿需要滴眼液治疗高眼压。从高眼压诊断到开始治疗的中位时间间隔为9天（范围5-31天）。在肾病综合征复发时，所有在首次发作时接受过高眼压治疗的儿童都需要再次接受高眼压治疗。结论泼尼松龙治疗初期应进行常规眼科检查。此外，患有高眼压发作的儿童随着肾病综合征的复发，其再次出现的风险可能更大。
BackgroundPrednisolone, the first-line treatment for children with nephrotic syndrome, causes severe side effects. One of these side effects is ocular hypertension, which can result in severe and permanent visual disturbance. However, the exact prevalence, severity and timing of development of ocular hypertension have yet to be fully explored in this pediatric patient group.MethodsIn this retrospective cohort study, children with nephrotic syndrome treated with prednisolone for their first episode were analyzed. Intraocular pressure was screened with an iCare® tonometer and confirmed with Goldmann applanation tonometry before the initiation of prednisolone treatment and at 1 and 4 weeks thereafter.ResultsA total of 26 children with nephrotic syndrome were included in this study, of whom eight (30.8 %) required treatment with eye drops for ocular hypertension. The median time interval between the diagnosis of ocular hypertension and start of treatment was 9 (range 5–31) days. At relapse of nephrotic syndrome, all children who had undergone treatment for ocular hypertension in their first episode again required treatment for ocular hypertension.ConclusionsRoutine ophthalmologic examination should be conducted from the early phase after the start of prednisolone treatment. In addition, children with episodes of ocular hypertension may be at greater risk of its reappearance with relapse of the nephrotic syndrome.