Abstract
BACKGROUND--Although posterior subcapsular cataract complicates both systemic and topical corticosteroid therapy, the literature on the effects of inhaled corticosteroids is conflicting. METHODS--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. RESULTS--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. CONCLUSIONS--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.
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Selected References
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- BLACK R. L., OGLESBY R. B., VON SALLMANN L., BUNIM J. J. Posterior subcapsular cataracts induced by corticosteroids in patients with rheumatoid arthritis. JAMA. 1960 Sep 10;174:166–171. doi: 10.1001/jama.1960.63030020005014. [DOI] [PubMed] [Google Scholar]
- Fournier C., Milot J. A., Clermont M. J., O'Regan S. The concept of corticosteroid cataractogenic factor revisited. Can J Ophthalmol. 1990 Dec;25(7):345–347. [PubMed] [Google Scholar]
- Nassif E., Weinberger M., Sherman B., Brown K. Extrapulmonary effects of maintenance corticosteroid therapy with alternate-day prednisone and inhaled beclomethasone in children with chronic asthma. J Allergy Clin Immunol. 1987 Oct;80(4):518–529. doi: 10.1016/0091-6749(87)90002-9. [DOI] [PubMed] [Google Scholar]
- Rooklin A. R., Lampert S. I., Jaeger E. A., McGeady S. J., Mansmann H. C., Jr Posterior subcapsular cataracts in steroid-requiring asthmatic children. J Allergy Clin Immunol. 1979 Jun;63(6):383–386. doi: 10.1016/0091-6749(79)90210-0. [DOI] [PubMed] [Google Scholar]
- Russell G. Inhaled corticosteroid therapy in children: an assessment of the potential for side effects. Thorax. 1994 Dec;49(12):1185–1188. doi: 10.1136/thx.49.12.1185. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Simons F. E., Persaud M. P., Gillespie C. A., Cheang M., Shuckett E. P. Absence of posterior subcapsular cataracts in young patients treated with inhaled glucocorticoids. Lancet. 1993 Sep 25;342(8874):776–778. doi: 10.1016/0140-6736(93)91541-s. [DOI] [PubMed] [Google Scholar]
- Tinkelman D. G., Reed C. E., Nelson H. S., Offord K. P. Aerosol beclomethasone dipropionate compared with theophylline as primary treatment of chronic, mild to moderately severe asthma in children. Pediatrics. 1993 Jul;92(1):64–77. [PubMed] [Google Scholar]
- Urban R. C., Jr, Cotlier E. Corticosteroid-induced cataracts. Surv Ophthalmol. 1986 Sep-Oct;31(2):102–110. doi: 10.1016/0039-6257(86)90077-9. [DOI] [PubMed] [Google Scholar]