Corticosteroid-induced intraocular pressure elevation in the pediatric patients

Abstract

Background: Corticosteroids have been one of the most frequently used therapeutics in ophthalmology over the past decades, known for their potent anti-inflammatory and immunosuppressive actions. Intraocular pressure elevation has proven to be a significant ocular side effect that could accompany steroid use. However, the information on ocular-hypertensive corticosteroid response is scant in children. We aim to systematically describe the corticosteroid-induced intraocular pressure elevation in the pediatric age group. Methods: PubMed, Embase, Web of Science, Cochrane Library, Latin American and Caribbean Health Sciences Literature, and the Chinese Biomedical Literature database will be searched for potential articles from database inception to April 29, 2021. No language restrictions will be applied. Studies involving patients less than 18 years old receiving corticosteroids will be included. We will screen abstracts for relevance, extract data, and assess the risk of bias in duplicate. We will rate the certainty of evidence using the Grading of Recommendations Assessment Development and Evaluation approach. The primary outcome will be the intraocular pressure in pediatric patients group. We will provide a narrative synthesis of the findings. Results: The systematic review will provide high-quality evidence to assess the relationship between dosage, frequency, route of administration, and duration of corticosteroid on intraocular pressure in children. Conclusion: The systematic review will provide evidence to assess the safety of corticosteroid for ocular diseases in pediatric population. PROSPERO registration number: CRD42021252298.

First Evidence Indicates the Physiology- and Axial-Myopia-Dependent Profiles of Steroid Hormones in Aqueous Humor

“…Zhang et al [17] measured estrogen and progesterone (P) in human AH using enzyme-linked immunosorbent assay and found that the hormone levels in AH were lower than those in serum with a gender-independent mode and did not find a difference between cataracts and non-cataracts. Many studies revealed that high intraocular pressure could be attributed to locally or systemically administered glucocorticoids [18][19][20][21][22]. Porter and Silber [22] first claimed that topical steroid therapy in AH could increase the risk of higher intraocular pressure by more than long-term systemic therapy in serum.…”