1. Graduate Training Base of the Third Medical Centre of Chinese PLA General Hospital, Jinzhou Medical University, Jinzhou 121001,China; 2. Department of Neurology, 3.Department of Ophthalmology, the Third Medical Centre of Chinese PLA General Hospital, Beijing 100039,China
Abstract:Objective To analyze the effects of long-term use of corticosteroids on high intraocular pressure and cataracts and related risk factors in patients with Duchenne muscular dystrophy (DMD). Methods The data on 158 DMD patients with detailed results of eye examinations and treated between August 2018 and December 2020 was retrospectively analyzed. According to whether corticosteroids were taken for a minimum of six months, the patients were divided into the corticosteroids group (n=103 cases) and corticosteroids free group (n=31 cases), so 24 cases that had taken corticosteroids for less than six months were not included in this study. The incidence of cataracts and high intraocular pressure in different groups was compared. Logistic regression analysis was used to study the correlations between cataracts and high intraocular pressure on one hand and age, duration of medication, types of corticosteroids, BMI, DP260 and DP71 on the other hand. Results In the corticosteroids free group, 1 case with intraocular pressure was reported, and no cataract was revealed. In the corticosteroids group, there were 13 cases (12.6%) with cataracts and 24 cases (23.3%) with high intraocular pressure, 1 case because of cataract was treated with surgery. Long-term use of corticosteroids was more likely to cause cataracts or high intraocular pressure (P<0.01). The incidence of cataracts and high intraocular pressure was 27.3% (3/11) and 27.3% (3/11) in the deflaxacort group (n=11), respectively, compared with 10.9% (10/92) and 22.8% (21/92) in the prednisone group. As indicated by logistic regression analysis, the incidence of cataracts was related to the type and duration corticosteroids. Moreover, there was no significant correlation between high intraocular pressure and age, duration of medication, types of hormones taken, BMI, DP260 or DP71. Conclusions DMD patients are more vulnerable to cataracts and high intraocular pressure after long-term use of corticosteroids. The types of corticosteroids taken and duration of medication are independent risk factors for cataracts. Besides, the longer corticosteroids are taken, the more likely deflazacort is to lead to cataracts.
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