Original articleUse of Inhaled and Oral Corticosteroids and the Long-term Risk of Cataract
Section snippets
Patients and Methods
The BMES is a population-based cohort study of vision and common eye and systemic conditions in a population aged 49 years and older, resident of a defined 2-postcode region west of Sydney, Australia. At baseline (1992–1994), 3654 (82.4% of eligible) persons participated. Surviving participants were invited to attend follow-up examinations after 5 (1997–1999) and 10 years (2002–2004). The study was approved by the University of Sydney and the Sydney West Area Health Service Human Research
Results
Of the original cohort of 3654 baseline participants, 2335 (63.9% of the original cohort; 75.1% of survivors) were reexamined after 5 years and 1952 (53.4% of the original cohort; 75.6% of survivors) were reexamined after 10 years. Thus, a total of 2564 participants were reexamined at least once after the baseline examination. After excluding participants with the corresponding cataract types at baseline and those with either missing or ungradable lens photographs, there were 2030 participants
Discussion
In this population-based cohort of older Australians, an adverse long-term risk of PSC and nuclear cataract subtypes associated with the use of both inhaled and oral corticosteroids was confirmed, particularly among persons who were current users at the baseline examinations. Further stratified analyses showed that the adverse influence of inhaled corticosteroids on the development of these 2 cataract subtypes was evident only among participants who had ever used oral corticosteroids in the
References (34)
- et al.
Alternative agents in asthma
J Allergy Clin Immunol
(2001) - et al.
Risk of cataract among users of intranasal corticosteroids
J Allergy Clin Immunol
(2000) - et al.
Association of ocular cataracts with inhaled and oral steroid therapy during long-term treatment of asthma
J Allergy Clin Immunol
(1993) - et al.
Inhaled and nasal corticosteroids: factors affecting the risks of systemic adverse effects
Pharmacol Ther
(1999) Systemic side effects of inhaled corticosteroids in patients with asthma
Respir Med
(2006)- et al.
Inhaled corticosteroids: past lessons and future issues
J Allergy Clin Immunol
(2003) - et al.
Prevalence of age-related maculopathy in Australia: the Blue Mountains Eye Study
Ophthalmology
(1995) - et al.
Prevalence of cataract in Australia: the Blue Mountains Eye Study
Ophthalmology
(1997) - et al.
Corticosteroid-induced cataracts
Surv Ophthalmol
(1986) - et al.
Guideline-defining asthma clinical trials of the National Heart, Lung, and Blood Institute's Asthma Clinical Research Network and Childhood Asthma Research and Education Network
J Allergy Clin Immunol
(2007)
Effect of intravenous immunoglobulin on steroid consumption in patients with severe asthma: a double-blind, placebo-controlled, randomized trial
J Allergy Clin Immunol
Prospects for antihistamines in the treatment of asthma
J Allergy Clin Immunol
Efficacy and tolerability of anti-asthma herbal medicine intervention in adult patients with moderate-severe allergic asthma
J Allergy Clin Immunol
Use of inhaled corticosteroids and the risk of cataracts
N Engl J Med
Cataracts and inhaled corticosteroids
N Engl J Med
Association of inhaled corticosteroid use with cataract extraction in elderly patients
JAMA
Low-dose inhaled and nasal corticosteroid use and the risk of cataracts
Eur Respir J
Cited by (110)
Comorbidity Burden in Severe and Nonsevere Asthma: A Nationwide Observational Study (FINASTHMA)
2024, Journal of Allergy and Clinical Immunology: In PracticeNeobavaisoflavone inhibits allergic inflammatory responses by suppressing mast cell activation
2022, International ImmunopharmacologyCitation Excerpt :At the same time, the progression of this chronic disease remains compromised in other cases [5]. Moreover, it has been suggested that long-term use of existing asthmatic medications, especially inhaled corticosteroids (ICSs), may cause side effects, such as pharyngitis, immunosuppression, mood changes, hypothalamic-pituitaryadrenal axis suppression, osteoporosis, and the development of cataracts in elderly patients [6–8]. Therefore, it is of great importance to discover new potential drugs to complement and improve the medication pool that can be used to treat asthma.
Interaction of alpha-crystallin with four major phospholipids of eye lens membranes
2021, Experimental Eye ResearchCitation Excerpt :A cataract is a medical condition in which the eye lens gradually becomes opaque, and vision will be blurred. The causes of cataract include aging (Bron et al., 2000; Truscott, 2005), genetics (Hejtmancik and Kantorow, 2004; Shiels and Hejtmancik, 2007), diabetes (Klein and Klein, 1997; Pollreisz and Schmidt-Erfurth, 2010), hypertension (Leske et al., 1999), obesity (Kuang et al., 2005; Weintraub et al., 2002), corticosteroids and statin medicine to reduce cholesterol (Erie et al., 2016; Lai et al., 2013; Wang et al., 2009), smoking (Solberg et al., 1998), significant alcohol consumption (Gong et al., 2015; Hiratsuka and Li, 2001), eye injury (Khatry et al., 2004; Négrel and Thylefors, 1998), radiation (Jacob, 2013; Lipman et al., 1988; Uwineza et al., 2019), and high myopia (Hoffer, 1993; Ignjatović, 1998; Metge and Donnadieu, 1993). Among these causes, aging is the most common cause of cataract in which the association of α-crystallin, a most common lens protein, with the fiber cell plasma membrane of the eye lens increases progressively (Boyle and Takemoto, 1996; Cenedella and Fleschner, 1992; Chandrasekher and Cenedella, 1995; Datiles et al., 2016; Friedrich and Truscott, 2009, 2010; Su et al., 2011).
Signs, symptoms, and clinical forms of cataract in adults
2020, Journal Francais d'OphtalmologieHormones and Drugs Affecting Hormonal Mechanisms
2020, Drug-Induced Ocular Side Effects, Eigtht EditionAssociation between dexamethasone exposure and visually significant cataracts in multiple myeloma
2024, American Journal of Hematology
Manuscript no. 2008-981.
Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Supported by the Australian National Health & Medical Research Council, Canberra, Australia (grant nos.: 974159, 211069).