Outcome of Ocular Steroid Hypertensive Response in Children
Outcome of Ocular Steroid Hypertensive Response in Children
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DOI：
10.1097/ijg.0000000000000209
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发表时间：
2016-04-01
影响因子：
2
通讯作者：
Pandav, Surinder S.
中科院分区：
文献类型：
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作者：
Kaur, Savleen;Dhiman, Indu;Pandav, Surinder S.
目的：本研究的目的是分析某三级眼科中心12岁以下儿童类固醇性高眼压的流行病学概况和结果。方法：回顾性分析2005年7月至2012年12月在我中心儿童青光眼门诊就诊的患者的住院记录。类固醇引起的高眼压被定义为在摄入任何形式的类固醇后伴有或不伴有青光眼视神经病变的眼内压(IOP) > 21 mm Hg（或比基线增加> 6 mm）。记录了人口统计资料、治疗细节和IOP、前段和后段的结果。主要观察指标为治疗后眼压的控制。结果：获得性儿童青光眼患者中，24%为类固醇性高眼压（150例患者中有36例）（平均年龄9.2±2.4岁）。我们研究了36例患者的57只眼，服用类固醇后眼压低于21毫米汞柱。在36例患者中，22例双侧类固醇性高血压反应。其中15例（41.6%）因春性结膜炎接受类固醇治疗，16例（22只眼）仅能停药，13例（25只眼）经药物治疗控制，7例（10只眼）需手术治疗。在最后一次随访中，80.5%的患者获得了良好的结局（定义为使用/不使用局部抗青光眼药物治疗时Hg < 21 mm）（平均17.4 +/- 23.47个月；范围4个月至8个月）。结论：本研究重点关注儿童类固醇药物对眼压的副作用。在许多情况下，人们可以避免使用类固醇，并考虑非类固醇/抗炎替代品。停用类固醇和抗青光眼药物能有效控制IOP（80.5%）。
Purpose: 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.Methods: 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.Results: 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).Conclusions: 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%).