Reversibility of Corticosteroid-Associated Cataracts in Children with the Nephrotic Syndrome

Forman, Alan R.; Loreto, James A.; Tina, Leticia U.

doi:10.1016/0002-9394(77)90328-2

Cited by 53 publications

(18 citation statements)

References 4 publications

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“…It has been shown in nephrotic children with posterior subcapsular cataracts induced by corticosteroid therapy that cataract reversal by intermittent corticosteroid therapy tends to occur more easily in cases with mild cataracts than in those with severe cataracts [7]. Taken together with the results obtained in the present study, it may be assumed that the membrane function is maintained near the normal level in lenses of patients with reversed steroid cataracts.…”

Section: Discussionsupporting

confidence: 74%

“…Later, several reports indicated an increased prevalence of posterior subcapsular cataracts in children being treated with corticosteroids for various diseases [2,3], in renal transplant recipients receiving enormous corticosteroid dosages required for immunosuppression [4], and in diabetic patients treated with unilateral topical dexamethasone for a long period in an attempt to control their retinopathy [5]. It has also been reported that posterior subcapsular cataracts in nephrotic and asthmatic children and in renal transplant recipients receiving a prolonged therapy with corticosteroids are reversed by intermittent therapy or by reduction of their dosage [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Partial Reversal of Methylprednisolone-Induced Opacity in Isolated Rat Lenses

Ohta

Okada²

2002

Ophthalmic Res

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We examined whether opacity is reversed in isolated rat lenses with opacities of different grades induced by methylprednisolone treatment by withdrawal of the steroid treatment. Transparent lenses isolated from male Wistar rats aged 6 weeks were incubated in TC-199 medium containing methylprednisolone hemisuccinate (1.5 mg/ml) for 24 or 48 h to induce opacities of two different grades (one was a slight cortical opacity around the equator and the other a heavy cortical opacity spreading from the equator to the cortex). In the slightly opaque lenses, water content was preserved at the level of transparent lenses untreated with steroid, although a 3.2-fold increase in Na⁺/K⁺ ratio and a 20% decrease in Na⁺,K⁺-ATPase activity were observed. In contrast, in the heavily opaque lenses, a significant increase in water content was accompanied by a 31.0-fold increase in Na⁺/K⁺ ratio and a 27% decrease in Na⁺,K⁺-ATPase activity. When the slightly and heavily opaque lenses were further incubated in steroid-free medium for 24 or 48 h, a partial opacity reversal was found in the slightly opaque lenses, but not in the heavily opaque lenses. In the slightly opaque lenses incubated in steroid-free medium for 48 h, increased Na⁺/K⁺ ratio and decreased Na⁺,K⁺-ATPase activity were restored to nearly the levels of untreated transparent lenses. Incubation of the heavily opaque lenses in steroid-free medium for 48 h caused further slight increases in water content and Na⁺/K⁺ ratio and further slight decrease in Na⁺,K⁺-ATPase activity. These results indicate that opacity is partially reversed in rat lenses with a slight opacity induced by methylprednisolone hemisuccinate when the steroid treatment is withdrawn, and suggest that recovery of impaired lens membrane function could be involved in this in vitro partial opacity reversal.

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Section: Discussionsupporting

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Partial Reversal of Methylprednisolone-Induced Opacity in Isolated Rat Lenses

Ohta

Okada²

2002

Ophthalmic Res

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“…It has not been demonstrated that early ophthalmologic examinations can significantly lower the risk of glaucoma and cataracts. Previous studies reported that 10-56 % of children with renal disease, and treated with steroids, developed cataracts [66][67][68][69][70][71][72][73]. With respect to glaucoma, some studies found no increase in intraocular pressure; [72,73] however, other studies reported an increase of intraocular pressure in 20 % of the patients [71,74].…”

Section: Explanationmentioning

confidence: 95%

“…The onset rate of posterior subcapsular cataracts does not appear to have a significant association with dose volume or steroid therapy, [66][67][68][69] suggesting that steroid sensitivity may be responsible. [69] Kobayashi et al and Hayasaka et al [70,71] reported that dose volume and steroid therapy duration are both associated with the rate of formation of cataracts.…”

Section: Cataractsmentioning

confidence: 99%

Clinical practice guideline for pediatric idiopathic nephrotic syndrome 2013: general therapy

et al. 2015

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“…The prevalence appears to have been influenced by the daily dose, cumulative dose, duration of treatment, patient age, and patient ethnic origin [6]. They have been reported to resolve partially or completely after removal from the corticosteroids, or may progress despite withdrawal [3,7,8].…”

Section: Cataractsmentioning

confidence: 95%

Ocular toxicity of systemic asthma and allergy treatments

Bielory

2006

Curr Allergy Asthma Rep

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Systemic medications, such as antihistaminic and anti-inflammatory agents used in the treatment of asthma and allergy, may have adverse effects on the eye. The major adverse effects on the eye have included cataracts, glaucoma, and tear-film dysfunction (dry-eye syndrome). The use of inhaled corticosteroids (bronchial and nasal) has been associated with mild systemic effects when compared with oral corticosteroids. The development of cataracts and glaucoma has been more commonly associated with earlier "hard" oral and inhaled steroids that affected individuals with an inherent high susceptibility or those who used them for several years. Whereas oral antihistamines commonly have an effect on allergies within hours, they also may exacerbate dry-eye complaints that commonly complicate symptoms with various forms of tear film dysfunction or conjunctival hyperreactivity. Clinicians should be aware that other systemic agents may complicate their attempts to maximize the treatment of ocular allergies.

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Reversibility of Corticosteroid-Associated Cataracts in Children with the Nephrotic Syndrome

Cited by 53 publications

References 4 publications

Partial Reversal of Methylprednisolone-Induced Opacity in Isolated Rat Lenses

Partial Reversal of Methylprednisolone-Induced Opacity in Isolated Rat Lenses

Clinical practice guideline for pediatric idiopathic nephrotic syndrome 2013: general therapy

Ocular toxicity of systemic asthma and allergy treatments

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