Incidence of cataract and glaucoma in children with nephrotic syndrome undergoing steroid treatment

Abstract

Background Nephrotic syndrome (NS) is by far, the most common glomerular disease in childhood period and is considered as one of the main aetiologies of child exposure to systemic steroids. High-dose corticosteroids for NS, are usually prescribed by pediatrians for a long period. Posterior subcapsular cataract (PSC) and increased intraocular pressure (IOP) are the two most common ocular complications associated with steroid treatment. The exact incidence, prevalence, severity, and time of cataract and glaucoma onset in those childrens have not yet been thoroughly investigated. Aim Evaluating the incidence of cataract and glaucoma in children with NS receiving steroid treatment during and after treatment cessation. Patients and methods This cohort prospective study was done at the Pediatric Nephrology Clinic at Zagazig University Children’s Hospital in co-operation with the Department of Ophthalmology, Zagazig University, for detailed eye examination. Totally 48 children with primary NS who received corticosteroids either as a single treatment or with other treatment modalities for more than 3 months were included in our study. Clinical features plus laboratory tests confirmed by renal biopsy were the main parameters used in the diagnosis of NS. Results Posterior subcapsular cataracts (PSC) were observed in 14 patients (29.2%). All studied patients had normal intraocular pressure ranging between 10 and 20 mmHg in both eyes during the follow-up period with no glaucomatous optic disc changes observed. Conclusion A significant number of children with NS treated with steroids are liable to develop cataracts and glaucoma that may progress and need surgery to preserve vision, so they have to be well diagnosed and followed-up.