Are ocular complications of a high-dose glucocorticoid treatment appropriately monitored in patients with rheumatic diseases?

Rheumatol Int. 2013 Nov;33(11):2951-2. doi: 10.1007/s00296-012-2456-7. Epub 2012 Aug 22.

Abstract

Glucocorticoid is frequently used in treating various rheumatic conditions. However it is known to cause multiple toxicities including cataract or glaucoma. In this study, we examined whether patients with rheumatic diseases had appropriate ocular monitoring for glucocorticoid toxicities. From rheumatology clinics in South New Jersey of the USA, we retrospectively identified patients with ages between 18 and 60 years old who received a high accumulative dose of glucocorticoid, which was defined as glucocorticoid dose greater than prednisone 7.5mg/day × 6 months = 1,350 mg. We observed rheumatologists recommended eye examinations only in 14/37 (37.8 %) of patients. Family history was present for cataract in 13/37 (35.1 %) patients and for glaucoma in 6/37 (16.2 %) patients. Rheumatologists recommended eye examinations in 4/13 (30.7 %) and 0/6 (0 %) patients in each group. This study suggested that rheumatologists did not appropriately monitor ocular complications of a high dose glucocorticoid, even in patients with a positive family history.

Publication types

  • Letter

MeSH terms

  • Adult
  • Antirheumatic Agents / administration & dosage
  • Antirheumatic Agents / adverse effects*
  • Antirheumatic Agents / therapeutic use
  • Cataract / chemically induced*
  • Female
  • Glaucoma / chemically induced*
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / adverse effects*
  • Glucocorticoids / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Rheumatic Diseases / drug therapy*

Substances

  • Antirheumatic Agents
  • Glucocorticoids