Impact of Inhaled and Intranasal Corticosteroids Exposure on the Risk of Ocular Hypertension and Glaucoma: A Systematic Review and Meta-Analysis

被引:0
|
作者
Vinokurtseva, Anastasiya [1 ]
Fung, Matthew [1 ]
Li, Erica Ai [2 ]
Zhang, Richard [1 ]
Armstrong, James J. [1 ,2 ]
Hutnik, Cindy M. L. [1 ,2 ,3 ]
机构
[1] Schulich Sch Med & Dent, Dept Ophthalmol, 268 Grosvenor St, London, ON N6A 4V2, Canada
[2] Schulich Sch Med & Dent, Dept Pathol, London, ON, Canada
[3] St Josephs Healthcare, Ivey Eye Inst, London, ON, Canada
来源
CLINICAL OPHTHALMOLOGY | 2022年 / 16卷
关键词
corticosteroids; asthma; glaucoma; intranasal; inhalation; FUROATE NASAL SPRAY; OBSTRUCTIVE PULMONARY-DISEASE; LONG-TERM SAFETY; ENDOSCOPIC SINUS SURGERY; ONCE-DAILY CICLESONIDE; BONE-MINERAL DENSITY; OPEN-ANGLE GLAUCOMA; INTRAOCULAR-PRESSURE; FLUTICASONE PROPIONATE; BECLOMETHASONE DIPROPIONATE;
D O I
10.2147/OPTH.S358066
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Purpose: Starting in 2019, the Global Initiative for Asthma recommended the use of inhaled corticosteroids (ICS) as part of reliever combination therapy in patients 12 years of age and older, thus dramatically increasing the population exposure to ICS. ICS and intranasal corticosteroids (INS) are commonly used for a variety of respiratory diseases. Chronic steroid use is a well-known risk factor for elevated intraocular pressure (TOP) and glaucoma regardless of route of administration. This study aimed to determine the reported risk of glaucoma, ocular hypertension (OHT) and TOP elevation associated with ICS and INS use. Materials and Methods: Systematic literature search in MEDLINE, EMBASE, Cochrane, CINAHL, BIOSIS, and Web of Science databases from the date of inception identified studies that assess ocular outcomes related to glaucoma in ICS and INS users. Study selection, risk of bias assessment and data extraction were done independently in duplicate. Meta-analysis assessed glaucoma incidence, OHT incidence and TOP changes in patients using ICS and INS. Study adhered to PRISMA guidelines. Study protocol was registered with PROSPERO: CRD42020190241. Results: Qualitative and quantitative analyses included 65 and 41 studies, respectively. Incidence of glaucoma was not significantly different in either ICS or INS users compared to control over 45,457 person-years of follow-up. Similarly, no significant difference in OHT incidence over 4431 person-years was detected. In studies reporting TOP, a significantly higher TOP was observed (0.69 mmHg) in 857 ICS or INS users compared to 615 controls. However, no significant increase in TOP was observed within ICS or INS users when compared to pre-treatment baseline. Conclusion: Overall, use of ICS or INS does not significantly increase the incidence of glaucoma or OHT. However, ICS and INS patients had significantly higher IOPs compared to untreated patients. Awareness of these findings is significant in care of patients with additional risk factors for glaucoma.
引用
收藏
页码:1675 / 1695
页数:21
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