Steroid-induced ocular hypertension in Asian children with severe vernal keratoconjunctivitis
Steroid-induced ocular hypertension in Asian children with severe vernal keratoconjunctivitis
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DOI：
10.2147/opth.s32936
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发表时间：
2012-01-01
影响因子：
2.2
通讯作者：
Chan, Cordelia
中科院分区：
文献类型：
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作者：
Ang, Marcus;Ti, Seng-Ei;Chan, Cordelia
背景资料：我们描述了严重春季角结膜炎（VKC）儿童皮质类固醇反应的临床特征和危险因素。设计：回顾性，非对照，比较病例系列。参与者：来自新加坡三个三级中心的患者。方法：我们回顾了严重VKC（临床分级）患者。2)接受局部类固醇治疗，随访期至少为1年。采用Logistic回归分析确定皮质类固醇反应的危险因素。主要观察指标：皮质类固醇反应定义为眼内压（IOP）>21 mmHg（三个连续读数），或从基线上升超过16 mmHg，在没有其他可能的原因升高IOP开始类固醇治疗后。结果：145例患者中有41例（28.3%）出现皮质类固醇反应，其中8例（5.5%）进展为青光眼。VKC的总体平均发病年龄为9.9 ± 4.4岁。皮质类固醇使用时间较长（OR，5.06; 95% CI：1.04-25.56; P = 0.45）和局部地塞米松0.01%（OR，2.25; 95% CI：1.99-5.08; P = 0.40）与皮质类固醇反应相关。混合型VKC（OR，9.76，95%CI：3.55-26.77，P < 0.001），角膜缘新生血管≥ 3个象限（OR，6.33，95%CI：2.36-16.97，P <0.001）
Background: We describe clinical characteristics and risk factors for corticosteroid response in children with severe vernal keratoconjunctivitis (VKC).Design: Retrospective, noncontrolled, comparative case series.Participants: Patients from three tertiary centers in Singapore.Methods: We reviewed patients with severe VKC (clinical grade. 2) who were on topical steroid therapy, with a minimum follow-up period of 1 year post-presentation. Logistic regression was used to determine risk factors for corticosteroid response.Main outcome measure: Corticosteroid response was defined as intraocular pressure (IOP)>21 mmHg (three consecutive readings), or a rise of more than 16 mmHg from baseline, after commencement of steroid therapy in the absence of other possible causes of raised IOP.Results: Forty-one of 145 (28.3%) patients developed a corticosteroid response, of which eight (5.5%) progressed to glaucoma. The overall mean age of onset of VKC was 9.9 +/- 4.4 years. Longer duration of corticosteroid use (OR, 5.06; 95% CI: 1.04-25.56; P = 0.45) and topical dexamethasone 0.01% (OR, 2.25; 95% CI: 1.99-5.08; P = 0.40) were associated with corticosteroid response. Mixed type of VKC (OR, 9.76; 95% CI: 3.55-26.77; P < 0.001), the presence of limbal neovascularization of >= three quadrants (OR, 6.33; 95% CI: 2.36-16.97; P