Inhaled corticosteroids and effects on the eye

• systemic corticosteroid therapy is a known risk factor for the development of posterior subcapsular cataract
  
  
• there is evidence from an Australian study that the incidence of posterior subcapsular cataract was doubled in past users of inhaled steroids compared with non-users - patients in the study only had had minimal exposure to oral steroids
  
  
• a Canadian case-control study suggested a possible association between the use of regular high dose inhaled steroids and glaucoma in patients aged 66 years or older
  
  
• a study evaluated the evaluated the association between use of inhaled corticosteroids (ICS) -containing products, specifically fluticasone propionate/salmeterol fixed-dose combination (FSC), and incidence of cataracts and glaucoma among patients with COPD in a large electronic medical record database in the United Kingdom (3)
  • FSC or other ICS exposure was not associated with an increased odds of cataracts or glaucoma, nor was a dose-response relationship observed in this population-based nested case-control study of COPD patients in the United Kingdom

Reference:

• NEJM (1997), 337, 8-14.
• JAMA (1997), 277, 722-7.
• Miller DP et al. Long-term use of fluticasone propionate/salmeterol fixed-dose combination and incidence of cataracts and glaucoma among chronic obstructive pulmonary disease patients in the UK General Practice Research Database. Int J Chron Obstruct Pulmon Dis. 2011;6:467-76