INTRODUCTION:
Corticosteroids (CS) are the most important class of anti-inflammatory drugs, used frequently. The therapeutic outcome of corticosteroids have been known and are employed for more than 65 years. Though the major advancement in discovering the hidden molecular mechanisms has been made in the last 20-25 years. The use of corticosteroids for their highly potent action was at its peak during the 1960s and 1970s and ineluctably they were used inappropriately and uncritically, when the untoward effects became apparent and a stage to think about their lavish use in all forms arrived.
Adverse effects ranging from acne to intestinal perforation and adrenal crisis has been documented. Both short term or long-term corticosteroids use has their own side-effects involving major systems of the body. Potency, dose, duration, frequency and form of the drug used in various routes also contributes to the manifestation of adverse effects. Corticosteroids treatment brought adverse events of such a proportion that the upcoming major group of anti-inflammatory drugs, were named as nonsteroidal anti-inflammatory drugs (NSAIDs). Corticosteroids were voted by the American Contact Dermatitis Society as “Allergen of the year” in 2005.
Even today, they are the established therapy for reducing inflammation and immune activation in numerous disease conditions like asthma, rheumatoid, vascular, allergic, collagen, inflammatory bowel, dermatological, ocular and other systemic diseases and also in allotransplantation. Their utilization has leaping up continuously in recent years as their therapeutic effects are indispensable and had made marvels in managing certain disease conditions in spite of their adverse effects. For appropriate use of corticosteroids, a basic knowledge of pharmacology, clinical usage guidelines and adverse effects are essential. In this study, the prevalence of various ocular manifestation in patients on long term corticosteroids in multiple routes of administration had been analysed.
AIM OF THE STUDY:
To analyse the ocular effects of long term use of corticosteroids by various routes of administration for several disorders treated in a tertiary care hospital.
OBJECTIVES:
1. To study the prevalence of the ocular effects of long term use of corticosteroids in various diseases.
2. To emphasis the importance of regular ocular examination for the patients on long term steroid therapy.
MATERIAL AND METHODS:
A cross-sectional study involving 230 patients on long-term use of corticosteroids for various disorders attending eye op within our inclusion criteria were evaluated for any ocular manifestations in the department of Ophthalmology in a tertiary medical college hospital for a period of one year from Jan-2017 to Dec-2017.
OBSERVATION AND RESULTS:
Overall 50.4% (n=116) of the study group found with lens opacities, 39.1% (n=90) had elevated IOP, 6.5% (n=15) had elevated IOP with disc and visual field defects and 1.7% (n=4) had CSCR. The prevalence of lens opacities showed significant association with all routes of steroid intake, duration of the therapy and dose of the drug. The prevalence of elevated IOP showed significant association with the dosage of topical, topical with sub-tenon and inhalational steroids and no significance with oral and external steroids dose. But duration of therapy was significantly associated with elevated IOP prevalence.
CONCLUSION:
Prolong use of corticosteroids in any form with increase in dose raised the prevalence of ocular adverse effects. Pre-treatment documentation of baseline values and intermittent re-evaluation for side effects has to be intensified since the prevalence of adverse effects are found to be in significant numbers
