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

Ishii Mai; Horita Nobuyuki; Takeuchi Masaki; Matsumoto Hiromi; Ebina-Shibuya Risa; Hara Yu; Kobayashi Nobuaki; Mizuki Nobuhisa; Kaneko Takeshi

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

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Type: Academic journal

Author: Ishii Mai (Department of Ophthalmology and Visual Science Yokohama City University Graduate School of Medicine) Horita Nobuyuki (Department of Pulmonology Yokohama City University Graduate School of Medicine Yokohama Japan) Takeuchi Masaki (Department of Ophthalmology and Visual Science Yokohama City University Graduate School of Medicine)

Journal: 대한천식알레르기학회(구 대한알레르기학회) Allergy, Asthma & Immunology Research Allergy, Asthma & Immunology Research Vol.13 No.3 KCI Accredited Journals

Published: 2021.1

Pages: 435 - 449 (15page)

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

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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.

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

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Ishii Mai

Affiliation Department of Ophthalmology and Visual Science Yokohama City University Graduate School of Medicine