Czech and Slovak Ophthalmology 99 10.31348/2018/6/2 Original article Corticosteroid Induced Posterior Subcapsular Cataract Kačmar Jiří Cholevík Dalibor https://orcid.org/0000-0002-9412-8579 19 4 2019 6 2

Objective: A description of the development of a clinical ocular finding of 23 patients (35 eyes) with steroid-induced posterior subcapsular cataract of different source, focusing on its character and mechanism of origin. Methods: The medical records of 23 patients, 14 women, 9 men, median age 44.5 years (median 44 years, interval 29 - 52 years) were evaluated retrospectively and had undergone surgery from 5/2016 to 5/2018 at Gemini Eye Clinic Bělský les. All patients underwent a complex eye examination and cataract surgery with artificial intraocular lens implantation. Results: In all of these patients, the incidence of the various stages of the posterior subcapsular cataract was correlated with the use of steroid therapy locally, generally per os, inhaled or combined, mainly in pre-adolescent patients. Postoperatively, a significant improvement in CDVA (corrected distance visual acuity) was observed in all patients in the set. Conclusion: Steroid-induced cataract is a clinical diagnosis reserved for conditions of cataract formation in relation to the dose and duration of use of corticosteroid medication. The diagnostic diagram of this process seems to be unambiguous, requires a thorough examination of the ocular finding and carefuly obtain internal and pharmacological history of the patient. The basic treatment approach is cataract surgery, which should be performed by an experienced surgeon for a higher risk of possible complications.

 posterior subcapsular cataract corticoids presenilic age side effects References Allen, DB., Bielory, L., Derendorf, H. et al.: Inhaled corticosteroids: past lessons and future issues. J Allergy Clin Immunol, 112; 2003: 1-40. Agrawal, R., Murthy, S., Ganesh, SK. et al.: Cataract Surgery in Uveitis. [online] Int J Inflam. 548453; 2012: dostupné z www <http://doi.org/10.1155/2012/548453>10.1155/2012/548453 Black, RL., Oglesby, RB., Sallmann, L. et al.: Posterior subcapsular cataracts induced by corticosteroids in patients with rheumatoid arthritis. JAMA, 174; 1960: 150-155. Bureš J, Horáček J.: Základy vnitřního lékařství. Praha, Galén ce oka, Praha, Grada, 2003: 65–67. Cantrill, HL., Palmberg, PF., Zink, HA. et al.: Comparison of in vitro potency of corticosteroids with ability to raise intraocular pressure. Am J Ophthalmol, 79; 1975: 1012–1017. Crews, S. J.: Posterior Subcapsular Lens Opacities in Patients on Long-term Corticosteroid Therapy. BMJ, 1(5346); 1963: 1642.2–1647. Cumming, RG., Mitchell, P.: Inhaled corticosteroids and cataract: prevalence, prevention and management. Drug Saf. 20; 1999: 77–84. Cumming, RG., Mitchell, P., Leeder, SR.: Use of inhaled corticosteroids and the risk of cataracts. N Engl J Med, 337(1); 1997: 8-14. Dickerson, JE. Jr., Dotzel, E., Clark, AF.: Cataract: New Per - spectives from In vitro and Lens Culture Studies. Exp Eye Res, 65; 1997: 507–516. François, J., Victoria-Troncoso, V.: Corticosteroid Glaucoma. Ophthalmologica, 174; 1977: 195-209. Global strategy for asthma management and prevention. [online] Global Initiative for Asthma. Updated 2018: dostupné z WWW <https://www.ginasthma.org/2018-gina-report-global-strategy-for-asthma-management-and-prevention/> Gordon, DM., McLean, JM.: Effect of pituitary adrenocorticot - ropic hormone (ACTH) therapy in ophthalmologic conditions. JAMA, 142(16); 1950: 1271–1276. Hench, PS., Kendall, EC., Slocumb, CH. et al.: The effect of a hormone of the adrenal cortex (17-hydroxy-11-dehydrocorticosterone: compound E) and of pituitary adrenocortical hormone in arthritis: preliminary report. Ann Rheum Dis, 8; 1949 Jun: 97-104. Hutyrová, B.: Inhalační kortikosteroidy v léčbě bronchiálního astmatu máme se jich bát nebo být rád za jejich efekt. Klin Farmakol Farm, 29(3); 2015: 105–107. Jirásková, N.: Přehled léčby zánětů oka. v Rozsíval, P. In: Infek- Jobling, AI., Augusteyn, RC.: What causes steroid cataracts? A review of steroid-induced posterior subcapsular cataracts. Clin Exp Optom, 85(2); 2002 Mar: 61-75. Kuchyňka, P.: Oční lékařství 2., přepracované a doplněné vydání, Praha, Grada, 2016: 479. Oglesby, RB., Black, RL., Sallmann, L. et al: Cataracts in Rheumatoid Arthritis Patients Treated With Corticosteroids: Description and Differential Diagnosis. Arch Ophthal, 66; 1961: 519-523. Prokofyeva, E., Wegener, A., Zrenner, E.: Cataract prevalence and prevention in Europe: a literature review. Acta Ophthalmol, 91(5); 2013 Aug. 395-405. Saag, KG., Furst, DE., Barnes, PJ.: Major side effects of inhaled glucocorticoids. [online]. UpToDate. Jun 2018: Dostupný z WWW: < https://www.uptodate.com/contents/ major-side-effects-of-inhaled-glucocorticoids > Skalka, HW., Prchal, JT.: Effect of corticosteroids on cataract formation. Arch Ophthalmol, 98(10); 1980 Oct: 1773-7. Viktorinová M.: Kortikosteroidy pro lokální léčbu kožních chorob. Remedia, 13; 2003: 266–282. Vlček, J., Vytřísalová, M.: Klinická farmacie II, Praha, Grada, 2014, 24.