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Ocular complications in systemic corticosteroid users for inflammatory bowel disease

Poster Details

First Author: U.Taka Aydin TURKEY

Co Author(s):    O. Cekic              

Abstract Details



Purpose:

To determine ocular complications after systemic corticosteroid use in both ulcerative colitis and Chron's disease.

Setting:

Marmara University, Marmara Faculty of Medicine, Department of Ophthalmology

Methods:

Patients treated with oral corticosteroid for inflammatory bowel disease (n=131; mean age: 40 years; female: 71, male: 60) were classified into two groups: First group was composed of past chronic steroid using patients. Second group was composed of recent steroid users that used the drug within the last one year. All patients underwent a detailed ophthalmologic examination including anterior and posterior segment evaluation. Status of the crystalline lens was evaluated by slit lamp biomicroscope after full mydriasis. Intraocular pressure was measured by Goldman applanation tonometer. A 90-diopter lens as well as optical coherence tomography was used to determine retinal pathology.

Results:

Average duration of the disease was 95 months (range 2 to 480 months). Past chronic users included 103 patients (78%) while recent users were 28 (21.4%) patients. Intraocular presure exceeded 22 mmHg in 12 patients (9.2%), steroid induced cataract (posterior subcapsular cataract) was observed in 5 patients (3.8%). One patient developed central serous chorioretinopathy (0.4%). The distribution of steroid induced complications within two groups was as follows: Cataract was observed only in chronic users. Elevation of intraocular pressure was identified in 10 past chronic users (9.7%) and in 2 recent users (7.1%) (P> 0.05). Central serous chorioretinopathy was detected in a recent steroid user.

Conclusions:

Cataract was noted only in chronic users, as expected. Elevation of intraocular pressure was observed in both chronic and recent oral steroid users. In chronic users steroid itsef seems to be responsible for cataract development. However general inflammatory condition and steroid use most probably act in a concerted manner the induction of intraocular pressure rise and central serous chorioretinopathy. Systemic steroid induces ocular side effects time independetly in patients with inflammatory bowel disease. FINANCIAL INTEREST: NONE

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