Effects of inhaled fluticasone on intraocular pressure and central corneal thickness in asthmatic children without a family history of glaucoma

Abstract

Purpose:The aim of this study is to report the effects of fluticasone-inhaled corticosteroid on intraocular pressure (IOP) and central corneal thickness (CCT) of asthmatic children without a family history of glaucoma.Materials and Methods:In this prospective study, 93 children were divided into two groups: 69 asthmatic children with no family history of glaucoma who were taking inhaled fluticasone propionate 250 μg daily for at least 6 months (Group 1) and 24 age-matched control subjects without asthma (Group 2). Three measurements each, of IOP and CCT, were performed with a hand-held noncontact tonometer and a noncontact specular microscope, respectively, over a 12-week period. The order of IOP and CCT measured were randomized at each visit. Between-group comparison and the relationship between CCT and IOP measurements were investigated. P < 0.05 was statistically significant.Results:The mean age was 8 ± 2.4 years (range, 5–15 years) and 9 ± 2.9 years (range, 5–15 years) for Groups 1 and 2, respectively (P = 0.1337). The mean IOP was 14 ± 3.3 mmHg (range, 10–24 mmHg) and 14 ± 2.9 mmHg (range, 11–22 mmHg) for Groups 1 and 2, respectively (P = 0.3626). The mean CCT was 531 ± 30.1 μm (range, 467–601 μm) and 519 ± 47.0 μm (range, 415589 μm) for Groups 1 and 2, respectively (P = 0.1625). There was a weak but statistically significant correlation between IOP and CCT in Group 1 (Pearson's R = 0.3580, P = 0.0025).Conclusions:Inhaled fluticasone at the regular dose used in this study over a short period (6–24 months) was not associated with a significant effect on CCT and IOP measured with noncontact devices in asthmatic children between 5 and 15 years, without a family history of glaucoma. A weak correlation between IOP and CCT values in asthmatic children did exist.

The Effects of Intranasal, Inhaled and Systemic Glucocorticoids on Intraocular Pressure: A Literature Review

“…The study conducted by Nath et al in 2017 showed 57 out of 405 subjects to have had an IOP higher than 22 mmHg after the intake of inhaled glucocorticoids, although no mention of statistical significance was made [ 33 ]. The eight remaining articles did not show any significant effect of inhaled glucocorticoids on IOP [ 11 , 18 , 34 , 35 , 36 , 37 , 38 , 39 ].…”

Ocular Surface, Intraocular Pressure, and Lens Condition in Bronchodilator and Steroid-Treated Patients with Chronic Pulmonary Disease

“…In the present study, inhaled or nebulized corticosteroids had no effect on intraocular pressure. Prolonged administration of high doses of ICS was observed to increase the risk of composite OH or open-angle glaucoma [8]; short-term administration of ICS was reported to have no significant effect on IOP or central corneal thickness in asthmatic children with no familial history of glaucoma [21]. Mitchell et al [22] proposed a link between the use of ICSs and the presence of increased IOP or glaucoma in patients who had a family history of glaucoma.…”

Glucocorticoid-Induced Ocular Hypertension and Glaucoma

“…Similarly, in a pediatric study conducted by Alsaadi et al, it was observed in children between 5 and 15 years of age there was no association between normal dose GC and the development of elevated IOP. 154 In 2021, a comprehensive meta-analysis that included 18 studies and 31,665 subjects was conducted by Ishii et al to determine the association between inhaled GC and GIOHT/GIG. 228 The results of their analysis showed no evidence that linked inhaled GC with ocular hypertension, glaucoma prevalence, or glaucoma incidence.…”