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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 대한천식알레르기학회 2021 Allergy, Asthma & Immunology Research Vol.13 No.3
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.
Horie, Yukihiro,Meguro, Akira,Kitaichi, Nobuyoshi,Lee, Eun Bong,Kanda, Atsuhiro,Noda, Kousuke,Song, Yeong Wook,Park, Kyung Sook,Namba, Kenichi,Ota, Masao,Inoko, Hidetoshi,Mizuki, Nobuhisa,Ishida, Susu Oxford University Press ; Distributed by Mercury I 2012 Rheumatology Vol.51 No.6
<P>Beh?et's disease is one of the major aetiologies of uveitis causing blindness in Asian countries. A genome-wide association study identified six microsatellite markers as disease susceptibility loci for Japanese patients with Beh?et's disease. To confirm our recent results, these microsatellite markers were examined in a Korean population as a replication study.</P>