Prevalence of Steroid-Induced Cataract and Glaucoma in Chronic Obstructive Pulmonary Disease Patients Attending a Tertiary Care Center in India.
OBJECTIVE
Exposure to corticosteroids is known to be associated with an increased risk of cataract and glaucoma. This study was undertaken to determine the prevalence of steroid-induced cataract and glaucoma in patients with chronic obstructive pulmonary disease (COPD) and to assess a dose-response relationship between them.


METHODS
This was a prospective observational study.


METHODS
We identified all COPD patients aged 50 years or older, with minimum steroid exposure of 4 months and on inhaled corticosteroids from March 2014 to March 2015. Average daily dose of inhaled corticosteroids was defined as low (1-250 µg), medium (251-500 µg), and high (501-1000 µg) using fluticasone propionate equivalents.


RESULTS
We screened 405 COPD patients, of which 48 were dropouts. We identified 58 cataract and 14 glaucoma patients with a prevalence of 16.24% and 3.92%, respectively. We also observed a dose-response relationship with the highest prevalence of cataract (39.6%) and glaucoma (42.8%) at daily doses of 501-1000 µg fluticasone propionate equivalents.


CONCLUSIONS
It is evident that higher doses and longer duration of inhaled corticosteroid in COPD patients are associated with a higher prevalence of cataract and glaucoma.
Upgraded Department of Ophthalmology, S. N. Medical College, Agra, India.
Tirupati
T
Nath
Upgraded Department of Ophthalmology, S. N. Medical College, Agra, India.
Subham Sinha
SS
Roy
Upgraded Department of Ophthalmology, S. N. Medical College, Agra, India.
Himanshu
H
Kumar
Upgraded Department of Ophthalmology, S. N. Medical College, Agra, India.
Rachit
R
Agrawal
Department of Tuberculosis and Chest Diseases, S. N. Medical College, Agra, India.
Santosh
S
Kumar
Upgraded Department of Ophthalmology, S. N. Medical College, Agra, India.
S K
SK
Satsangi
D000280:Administration, Inhalation; D000368:Aged; D001993:Bronchodilator Agents / Q000009:adverse effects*; D002386:Cataract / Q000139:chemically induced* / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D005260:Female; D000068298:Fluticasone / Q000009:adverse effects*; D005901:Glaucoma / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D012307:Risk Factors; D013256:Steroids / Q000009:adverse effects*
D001993:Bronchodilator Agents; D013256:Steroids; D000068298:Fluticasone
chronic obstructive pulmonary disease; steroid-induced cataract; steroid-induced glaucoma