Severe ocular hypertension secondary to systemic corticosteroid treatment in a child with nephrotic syndrome

• Type: Article in International Scientific Journal
• Date: 2012

Authors

Brito, PN (Author) Other; Silva, SE (Author) Other; Cotta, JS (Author) Other; Falcão-Reis F (Author) FMUP

Journal

Title: Clinical Ophthalmology

Vol. 6

Pages: 1675-1679

ISSN: 1177-5467

Publisher: Dove Medical Press

Indexing

Scopus - 13 Citations

Other information

Authenticus ID: P-008-7CR

DOI: 10.2147/opth.s36261

Abstract (EN): Purpose: To report a case of severe, acute ocular hypertension in a 6-year-old child, 7 days after initiating treatment with oral prednisolone, due to nephrotic syndrome. Methods: A 6-year-old female Caucasian child was diagnosed with nephrotic syndrome and treated with oral prednisolone (60 mg/day). Seven days later the child initiated complaints of headache, vomiting, ocular pain, and photophobia. Ophthalmologic examination revealed a severely increased intraocular pressure (IOP) of 52 mmHg in the right eye and 56 mmHg in the left eye. Anterior segment morphology was evaluated with ultrasound biomicroscopy. Optic disc status was evaluated by disc photography, kinetic perimetry, and optical coherence tomography. Results: Treatment was initiated with latanoprost, brimonidine, and the fixed association of timolol and dorzolamide. At each follow-up examination, progressively better control of IOP was obtained. Simultaneous with corticosteroid dosage decrease we were able to reduce antiglaucomatous medication while maintaining IOP under control. Ultrasound biomicroscopy revealed an open angle with normal anterior segment echographic findings. Perimetric evaluation revealed normal visual fields in both eyes. Four months after presentation, steroid treatment had been completed and IOP was 10 mmHg in both eyes without any antiglaucomatous medication. Optical coherence tomography revealed normal retinal nerve fiber layer thickness in all peripapillary sectors. Conclusions: Systemic steroid treatment can cause a severe, acute increase in IOP in children. Children undergoing steroid treatment should have routine ophthalmologic examinations during treatment duration. Prompt antiglaucomatous treatment prevents retinal nerve fiber layer damage and visual acuity loss. © 2012 Simpson et al.

Language: English

Type (Professor's evaluation): Scientific