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The Relationship Between Long-term Use of Intranasal Corticosteroid and Intraocular Pressure

Mohd Zain, Ayesha, MS(Ophthal)*; Md Noh, Umi K., MS(Ophthal); Hussein, Salina, MS(ORL); Che Hamzah, Jemaima, PhD*; Mohd Khialdin, Safinaz, MS(Ophthal)*; Md Din, Norshamsiah, PhD*

doi: 10.1097/IJG.0000000000001164
Original Studies

Purpose: The purpose of this study was to investigate the association between long-term intranasal steroid use and intraocular pressure (IOP) elevation.

Patients and Methods: In total, 100 eyes from 50 patients on long-term intranasal steroids (>2 y) for allergic rhinitis and 90 eyes from 45 controls were included in this study. Patients on other forms of steroids and risk factors for glaucoma were excluded. IOP was measured and nonmydriatic stereoscopic optic disc photos were taken for each eye. The vertical cup-to-disc ratio and the status of the optic disc were evaluated.

Results: The mean IOP for intranasal steroids group was significantly higher (15.24±2.31 mm Hg) compared to the control group (13.91±1.86 mm Hg; P=0.000). However, there were no significant differences in the vertical cup-to-disc ratio and the status of glaucomatous optic disc changes between the groups.

Conclusions: Prolonged use of intranasal steroids cause statistical significant increase in IOP in patients with allergic rhinitis although no significant glaucomatous disc changes were seen. We suggest patients on long-term use of intranasal steroid have a yearly eye examination to be monitored for IOP elevation and those with additional risk factors for glaucoma is closely monitored for glaucoma.

Departments of *Ophthalmology

Otorhinolaryngology, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Kuala Lumpur

Nilai Medical Center, Negeri Sembilan, Malaysia

Disclosure: A.M.Z. holds a Masters scholarship funded by the Government of Malaysia. The remaining authors declare no conflict of interest.

Reprints: Norshamsiah Md Din, PhD, Department of Ophthalmology, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia (e-mail:

Received July 26, 2018

Accepted December 8, 2018

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