잠시만 기다려 주세요. 로딩중입니다.

Inhaled Corticosteroid and Secondary Glaucoma: A Meta-analysis of 18 Studies

Allergy, Asthma & Immunology Research : AAIR 2021년 13권 3호 p.435 ~ 449
Ishii Mai, Takeuchi Masaki, Matsumoto Hiromi, Ebina-Shibuya Risa, Hara Yu, Kobayashi Nobuaki, Mizuki Nobuhisa, Kaneko Takeshi,
소속 상세정보
 ( Ishii Mai ) - Yokohama City University Graduate School of Medicine Department of Ophthalmology and Visual Science
 ( Takeuchi Masaki ) - Yokohama City University Graduate School of Medicine Department of Ophthalmology and Visual Science
 ( Matsumoto Hiromi ) - Yokohama City University Graduate School of Medicine Department of Pulmonology
 ( Ebina-Shibuya Risa ) - National Institutes of Health National Cancer Institute Pediatric Oncology Branch
 ( Hara Yu ) - Yokohama City University Graduate School of Medicine Department of Pulmonology
 ( Kobayashi Nobuaki ) - Yokohama City University Graduate School of Medicine Department of Pulmonology
 ( Mizuki Nobuhisa ) - Yokohama City University Graduate School of Medicine Department of Ophthalmology and Visual Science
 ( Kaneko Takeshi ) - Yokohama City University Graduate School of Medicine Department of Pulmonology

Abstract


Purpose: Guidelines and systematic reviews frequently warn of inhaled corticosteroid (ICS)-induced glaucoma. However, most of the published studies deny it.

Methods: We performed a systematic review of randomized, cohort, nested-case control, cross-sectional studies by using Meta-analyses of Observational Studies in Epidemiology statement. Four major databases, PubMed, EMBASE, Cochrane Search Manager, and the Web of Science Core Collection as well as meta-analysis were used. Studies comparing incidence, prevalence and intraocular pressure (IOP) between patients who were treated with and without ICSs were included. A random-model meta-analysis was performed using the inverse variance method.

Results: Out of 623 studies screened, 18 with 31,665 subjects were finally included. No significant difference between the 2 groups was observed for crude glaucoma incidence (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.86?1.04; P = 0.26; I 2 = 0%; P for heterogeneity = 0.57) as a primary endpoint, adjusted glaucoma incidence (OR, 0.90; 95% CI, 0.65?1.24; P = 0.64), crude prevalence (OR, 1.82; 95% CI, 0.23?14.19; P = 0.57), adjusted prevalence (OR, 1.22; 95% CI, 0.50?2.96; P = 0.66), IOP change during ICS treatment (mean difference [MD] +0.01 mmHg; 95% CI, ?0.19?0.20; P = 0.95), and single measurement IOP (MD +0.37 mmHg; 95% CI, ?0.24?0.97; P = 0.23). Time-to-event analysis for glaucoma development as one of the secondary endpoints (adjusted hazard ratio, 0.52; 95% CI, 0.28?0.96) suggested a reverse association between ICS and glaucoma.

Conclusions: The ophthalmological side effects of ICSs, such as glaucoma and intraocular hypertension, should not be exaggerated.

키워드

Asthma; chronic obstructive pulmonary disease; adrenal cortex hormones; glaucoma; meta-analysis; cohort studies; review; intraocular pressure

원문 및 링크아웃 정보

 

등재저널 정보