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Inhaled Steroid Can Lead To Increased Intra-Ocular Pressure In Children With Asthma: Presented at ESO

By Cameron Johnston

MADRID, SPAIN -- June 11, 2003 -- Using inhaled corticosteroids can cause a slight increase in intra-ocular pressure (IOP) in children with asthma, say researchers.

And, while the increase is not large - only 1.2 mmHg on average - it is an accepted fact that every 1 mmHg increase in IOP increases a person's risk of glaucomatous damage to the optic nerve by 10%. For that reason, investigators recommend that regular eye examinations, including IOP measurements become standard practice for children whose asthma is being treated with inhaled corticosteroids.

According to Dr. Evangelos Sioras, an ophthalmologist at the Triasio General Hospital, in Athens, the increased use of inhaled corticosteroids over the past decade has raised a number of issues for physicians and for patients, not the least of which is what effect these agents could have on a patient's eyes. It is well known, for example, that steroid use can lead to a transient increase in IOP among adults, but to date, no studies have been done in asthmatic children. He presented study findings here at the 14^th congress of the European Society of Ophthalmology has reported.

Although in this study, compliance on the part of the care-givers and the children themselves was a problem, Dr. Sioras said 15 children, mean age 10.6 years (range 6 to 14) underwent full ophthalmic investigations, including IOP measurements. In all, the children had 4 examinations, at 15 and 30 days after starting steroid treatment, and again at 15 and 30 days after treatment was suspended. The exact corticosteroid used was not important for the study, he said.

The study results showed a mean difference in IOP of 1.2 mmHg from the time the young patients were on-treatment compared with when they were off-treatment. Mean IOP on-treatment was 13.95 mmHg, compared with 12.75 off-treatment. The odds ratio for an increase in IOP between the children being on-treatment or off-treatment was 1.35 (p=.01)

Although this was a small study, Dr. Sioras said the results suggest that IOP should be monitored in asthmatic children who are using corticosteroids, and that more research is needed to determine the risk profile for children with asthma in terms of potential risk factors for damage to their eyes.

Finally, he said, it might be useful for family practitioners who are dealing with longer term pediatric asthma patients to consult an ophthalmologist periodically to determine whether, or if damage is occurring in the young patient's eyes.


[Study title: Ocular Hypertension Response To Inhaled And/Or Nasal Steroid Therapy For Asthma In Children. Abstract FP041]

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