Intraocular pressure changes in bronchial asthma patients on treatment with inhalational steroids at a tertiary hospital in Southern Nigeria

Abstract

Background: Elevated intraocular pressure (IOP) has been linked with the use of steroids.
Aim: This study aimed to evaluate the association between the use of inhalational steroids and IOP among patients receiving treatment for bronchial asthma.
Setting: It was a hospital-based cohort study at a tertiary hospital.
Methods: Newly diagnosed asthma patients yet to commence inhalational steroids as cohort 1 gotten from the Respiratory clinic and Family Medicine Department. Cohort 2 was the control group who were age and sex matched with cohort 1 gotten from patients visiting the Ophthalmology Clinic with mild ocular disorders (without any respiratory symptoms). Their baseline IOP and central corneal thickness were used to adjust for corrected IOP. The patients in cohort 1 were placed on inhalational fluticasone 250 mcg twice daily. The IOP was thereafter measured monthly over a period of 5 months for both cohorts.
Results: A total of 210 participants who were enrolled completed the study with 105 participants (mean age ± standard deviation 41.08 ± 11.10) in cohort 1 and another 105 participants (mean age 41.34 ± 10.55 years) in cohort 2. The mean IOP increase was 4.51 ± 2.15 right eye and 4.56 ± 2.03 left eye for cohort 1, while cohort had a mean IOP increase of 4.37 ± 2.40 and 3.83 ± 2.80 for the right and left eyes, respectively. There was no statistically significant difference in IOP increase from the first to third month of study, but a statistically significant association between inhaled steroid and IOP increase was observed in the fourth and fifth months of study (P < 0.005). The predictors of elevated IOP among study participants were primary or secondary level education and the presence of allergies.
Conclusion: The study showed a significant increase in IOP after 3 months of use of inhalational steroids.
Contribution: There is a need for physicians to liaise with ophthalmologists to monitor the IOP and associated risk of glaucoma of their asthmatic patients on inhalational steroids.