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Cataract development associated with long-term glucocorticoid therapy in Duchenne muscular dystrophy patients
- Source :
- Journal of American Association for Pediatric Ophthalmology and Strabismus. 22:192-196
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Purpose To evaluate the development of cataracts or elevated intraocular pressure (IOP) in patients with Duchenne muscular dystrophy (DMD) on long-term glucocorticoid (GC) treatment. Methods The medical records of DMD patients evaluated from 2010 to 2015 at a single center were reviewed retrospectively. The main outcome measures were prevalence of cataracts and elevated IOP, age of first detection of cataract, time from initial steroid use to first detection of cataract, and relative risk of cataract development for deflazacort versus prednisone treatment. Results Of 596 DMD patients, 514 underwent GC therapy; all but one was male. The racial distribution was 82.1% white, 1.0% African American, 5.0% Hispanic, 2.9% Asian, and 8.0% more than one race or “other.” The prevalence of cataracts was 22.4% in patients on GC therapy. The mean age at which cataract formation was first documented was 12.9 ± 4.1 years (IQR, 9.6-14.6). The mean time from initial steroid use to the first detection of cataract was 6.5 ± 3.6 years (IQR, 4.0-8.6). The odds of cataract development were 2.4-fold higher for patients on deflazacort compared with prednisone (95% CI, 1.3-4.5; P = 0.004). Only 7 patients (1.4%) underwent cataract surgery, at a mean age of 16.9 years (range, 10.7-24.6 years); all were on deflazacort. Among patients with available intraocular pressure measurements, elevated IOP occurred in only 1 patient (1.1%), who was on deflazacort. Conclusions In patients undergoing GC therapy for DMD, the rate of cataract formation was slow and well tolerated, with a higher risk among deflazacort patients. The percentage of patients requiring cataract extraction or with elevated IOP was very small. These findings suggest that a schedule of annual eye examinations is appropriate.
- Subjects :
- Male
0301 basic medicine
Intraocular pressure
medicine.medical_specialty
Time Factors
Adolescent
genetic structures
medicine.medical_treatment
Cataract Extraction
Single Center
Cataract
Tonometry, Ocular
Young Adult
03 medical and health sciences
0302 clinical medicine
Cataracts
Pregnenediones
Prednisone
Internal medicine
Prevalence
medicine
Humans
Muscular dystrophy
Child
Glucocorticoids
Intraocular Pressure
Retrospective Studies
business.industry
Cataract surgery
medicine.disease
eye diseases
Muscular Dystrophy, Duchenne
Deflazacort
Ophthalmology
030104 developmental biology
Relative risk
Pediatrics, Perinatology and Child Health
Female
Ocular Hypertension
sense organs
business
Immunosuppressive Agents
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- ISSN :
- 10918531
- Volume :
- 22
- Database :
- OpenAIRE
- Journal :
- Journal of American Association for Pediatric Ophthalmology and Strabismus
- Accession number :
- edsair.doi.dedup.....7ba3b468f33394874b9a7c4c7d20d72a