Steroid-induced ocular hypertension in Asian children with severe vernal keratoconjunctivitis

Steroid-induced ocular hypertension in Asian children with severe vernal keratoconjunctivitis

Marcus Ang,1 Seng-Ei Ti,1 Raymond Loh,1 Sonal Farzavandi,1 Rongli Zhang,2 Donald Tan,1 Cordelia Chan11Singapore National Eye Centre, Singapore; 2Singapore Eye Research Institute, SingaporeBackground: We describe clinical characteristics and risk factors for corticosteroid response in children with s...

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Autores principales: Ang M, Ti SE, Loh R, Farzavandi S, Zhang R, Tan D, Chan C
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2012
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Ophthalmology
RE1-994
Acceso en línea:https://doaj.org/article/2024e3aa51774fbc91f1596ee6edcc71
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spelling oai:doaj.org-article:2024e3aa51774fbc91f1596ee6edcc712021-12-02T07:13:25ZSteroid-induced ocular hypertension in Asian children with severe vernal keratoconjunctivitis1177-54671177-5483https://doaj.org/article/2024e3aa51774fbc91f1596ee6edcc712012-08-01T00:00:00Zhttp://www.dovepress.com/steroid-induced-ocular-hypertension-in-asian-children-with-severe-vern-a10605https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Marcus Ang,1 Seng-Ei Ti,1 Raymond Loh,1 Sonal Farzavandi,1 Rongli Zhang,2 Donald Tan,1 Cordelia Chan11Singapore National Eye Centre, Singapore; 2Singapore Eye Research Institute, SingaporeBackground: 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 < 0.001), and corneal involvement (OR, 3.51; 95% CI: 1.31–9.41; P = 0.012) were significant clinical risk factors after adjusting for potential confounders such as age, sex, ethnicity, duration, and type of corticosteroid used.Conclusion: Children on long-term oral corticosteroids with severe, mixed-type VKC and corneal involvement are more likely to develop corticosteroid response, and may require early treatment to prevent progression to glaucoma.Keywords: vernal keratoconjunctivitis, glaucoma, steroidsAng MTi SELoh RFarzavandi SZhang RTan DChan CDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2012, Iss default, Pp 1253-1258 (2012)
institution DOAJ
collection DOAJ
language EN
topic Ophthalmology
RE1-994
spellingShingle Ophthalmology
RE1-994
Ang M
Ti SE
Loh R
Farzavandi S
Zhang R
Tan D
Chan C
Steroid-induced ocular hypertension in Asian children with severe vernal keratoconjunctivitis
description Marcus Ang,1 Seng-Ei Ti,1 Raymond Loh,1 Sonal Farzavandi,1 Rongli Zhang,2 Donald Tan,1 Cordelia Chan11Singapore National Eye Centre, Singapore; 2Singapore Eye Research Institute, SingaporeBackground: 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 < 0.001), and corneal involvement (OR, 3.51; 95% CI: 1.31–9.41; P = 0.012) were significant clinical risk factors after adjusting for potential confounders such as age, sex, ethnicity, duration, and type of corticosteroid used.Conclusion: Children on long-term oral corticosteroids with severe, mixed-type VKC and corneal involvement are more likely to develop corticosteroid response, and may require early treatment to prevent progression to glaucoma.Keywords: vernal keratoconjunctivitis, glaucoma, steroids
format article
author Ang M
Ti SE
Loh R
Farzavandi S
Zhang R
Tan D
Chan C
author_facet Ang M
Ti SE
Loh R
Farzavandi S
Zhang R
Tan D
Chan C
author_sort Ang M
title Steroid-induced ocular hypertension in Asian children with severe vernal keratoconjunctivitis
title_short Steroid-induced ocular hypertension in Asian children with severe vernal keratoconjunctivitis
title_full Steroid-induced ocular hypertension in Asian children with severe vernal keratoconjunctivitis
title_fullStr Steroid-induced ocular hypertension in Asian children with severe vernal keratoconjunctivitis
title_full_unstemmed Steroid-induced ocular hypertension in Asian children with severe vernal keratoconjunctivitis
title_sort steroid-induced ocular hypertension in asian children with severe vernal keratoconjunctivitis
publisher Dove Medical Press
publishDate 2012
url https://doaj.org/article/2024e3aa51774fbc91f1596ee6edcc71
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AT tise steroidinducedocularhypertensioninasianchildrenwithseverevernalkeratoconjunctivitis
AT lohr steroidinducedocularhypertensioninasianchildrenwithseverevernalkeratoconjunctivitis
AT farzavandis steroidinducedocularhypertensioninasianchildrenwithseverevernalkeratoconjunctivitis
AT zhangr steroidinducedocularhypertensioninasianchildrenwithseverevernalkeratoconjunctivitis
AT tand steroidinducedocularhypertensioninasianchildrenwithseverevernalkeratoconjunctivitis
AT chanc steroidinducedocularhypertensioninasianchildrenwithseverevernalkeratoconjunctivitis
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