Severe ocular hypertension secondary to systemic corticosteroid treatment in a child with nephrotic syndrome

Pedro Nuno Brito,1 S&eacute;rgio Estrela Silva,1 Jos&eacute; Silva Cotta,1 Fernando Falc&atilde;o-Reis1,21Ophthalmology Department, Hospital S Jo&atilde;o, Porto, Portugal; 2Faculty of Medicine of Porto, University of Porto, Porto, PortugalPurpose: To report a case of...

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Autores principales:	Brito PN, Silva SE, Cotta JS, Falc&atilde;o-Reis F
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/762f84e6c03342078144baa801b20545
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spelling	oai:doaj.org-article:762f84e6c03342078144baa801b205452021-12-02T04:07:13ZSevere ocular hypertension secondary to systemic corticosteroid treatment in a child with nephrotic syndrome1177-54671177-5483https://doaj.org/article/762f84e6c03342078144baa801b205452012-10-01T00:00:00Zhttp://www.dovepress.com/severe-ocular-hypertension-secondary-to-systemic-corticosteroid-treatm-a11282https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Pedro Nuno Brito,1 S&eacute;rgio Estrela Silva,1 Jos&eacute; Silva Cotta,1 Fernando Falc&atilde;o-Reis1,21Ophthalmology Department, Hospital S Jo&atilde;o, Porto, Portugal; 2Faculty of Medicine of Porto, University of Porto, Porto, PortugalPurpose: To report a case of severe, acute ocular hypertension in a 6-year-old child, 7 days after initiating treatment with oral prednisolone, due to nephrotic syndrome.Methods: A 6-year-old female Caucasian child was diagnosed with nephrotic syndrome and treated with oral prednisolone (60 mg/day). Seven days later the child initiated complaints of headache, vomiting, ocular pain, and photophobia. Ophthalmologic examination revealed a severely increased intraocular pressure (IOP) of 52 mmHg in the right eye and 56 mmHg in the left eye. Anterior segment morphology was evaluated with ultrasound biomicroscopy. Optic disc status was evaluated by disc photography, kinetic perimetry, and optical coherence tomography.Results: Treatment was initiated with latanoprost, brimonidine, and the fixed association of timolol and dorzolamide. At each follow-up examination, progressively better control of IOP was obtained. Simultaneous with corticosteroid dosage decrease we were able to reduce antiglaucomatous medication while maintaining IOP under control. Ultrasound biomicroscopy revealed an open angle with normal anterior segment echographic findings. Perimetric evaluation revealed normal visual fields in both eyes. Four months after presentation, steroid treatment had been completed and IOP was 10 mmHg in both eyes without any antiglaucomatous medication. Optical coherence tomography revealed normal retinal nerve fiber layer thickness in all peripapillary sectors.Conclusions: Systemic steroid treatment can cause a severe, acute increase in IOP in children. Children undergoing steroid treatment should have routine ophthalmologic examinations during treatment duration. Prompt antiglaucomatous treatment prevents retinal nerve fiber layer damage and visual acuity loss.Keywords: glaucoma, children, corticosteroid, nephroticBrito PNSilva SECotta JSFalc&atilde;o-Reis FDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2012, Iss default, Pp 1675-1679 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Brito PN Silva SE Cotta JS Falc&atilde;o-Reis F Severe ocular hypertension secondary to systemic corticosteroid treatment in a child with nephrotic syndrome
description	Pedro Nuno Brito,1 S&eacute;rgio Estrela Silva,1 Jos&eacute; Silva Cotta,1 Fernando Falc&atilde;o-Reis1,21Ophthalmology Department, Hospital S Jo&atilde;o, Porto, Portugal; 2Faculty of Medicine of Porto, University of Porto, Porto, PortugalPurpose: To report a case of severe, acute ocular hypertension in a 6-year-old child, 7 days after initiating treatment with oral prednisolone, due to nephrotic syndrome.Methods: A 6-year-old female Caucasian child was diagnosed with nephrotic syndrome and treated with oral prednisolone (60 mg/day). Seven days later the child initiated complaints of headache, vomiting, ocular pain, and photophobia. Ophthalmologic examination revealed a severely increased intraocular pressure (IOP) of 52 mmHg in the right eye and 56 mmHg in the left eye. Anterior segment morphology was evaluated with ultrasound biomicroscopy. Optic disc status was evaluated by disc photography, kinetic perimetry, and optical coherence tomography.Results: Treatment was initiated with latanoprost, brimonidine, and the fixed association of timolol and dorzolamide. At each follow-up examination, progressively better control of IOP was obtained. Simultaneous with corticosteroid dosage decrease we were able to reduce antiglaucomatous medication while maintaining IOP under control. Ultrasound biomicroscopy revealed an open angle with normal anterior segment echographic findings. Perimetric evaluation revealed normal visual fields in both eyes. Four months after presentation, steroid treatment had been completed and IOP was 10 mmHg in both eyes without any antiglaucomatous medication. Optical coherence tomography revealed normal retinal nerve fiber layer thickness in all peripapillary sectors.Conclusions: Systemic steroid treatment can cause a severe, acute increase in IOP in children. Children undergoing steroid treatment should have routine ophthalmologic examinations during treatment duration. Prompt antiglaucomatous treatment prevents retinal nerve fiber layer damage and visual acuity loss.Keywords: glaucoma, children, corticosteroid, nephrotic
format	article
author	Brito PN Silva SE Cotta JS Falc&atilde;o-Reis F
author_facet	Brito PN Silva SE Cotta JS Falc&atilde;o-Reis F
author_sort	Brito PN
title	Severe ocular hypertension secondary to systemic corticosteroid treatment in a child with nephrotic syndrome
title_short	Severe ocular hypertension secondary to systemic corticosteroid treatment in a child with nephrotic syndrome
title_full	Severe ocular hypertension secondary to systemic corticosteroid treatment in a child with nephrotic syndrome
title_fullStr	Severe ocular hypertension secondary to systemic corticosteroid treatment in a child with nephrotic syndrome
title_full_unstemmed	Severe ocular hypertension secondary to systemic corticosteroid treatment in a child with nephrotic syndrome
title_sort	severe ocular hypertension secondary to systemic corticosteroid treatment in a child with nephrotic syndrome
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/762f84e6c03342078144baa801b20545
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Severe ocular hypertension secondary to systemic corticosteroid treatment in a child with nephrotic syndrome

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