Drugs & Aging

, Volume 29, Issue 12, pp 963–970

Corticosteroids and Open-Angle Glaucoma in the Elderly

A Population-Based Cohort Study
  • Michael W. Marcus
  • Rogier P. H. M. Müskens
  • Wishal D. Ramdas
  • Roger C. W. Wolfs
  • Paulus T. V. M. De Jong
  • Johannes R. Vingerling
  • Albert Hofman
  • Bruno H. C. Stricker
  • Nomdo M. Jansonius
Original Research Article

Abstract

Background

It is largely unknown if corticosteroid-induced open-angle glaucoma (OAG) is an entity that is limited to a few susceptible individuals or whether it contributes significantly to the overall population burden of OAG.

Objective

The aim of this study was to determine whether there is an association between corticosteroid use and the incidence of OAG in the general elderly population.

Methods

A prospective population-based cohort study was conducted in a general community setting. 3,939 participants of the Rotterdam Study aged 55 years and older for whom data from ophthalmic examinations at baseline and follow-up were available and who did not have glaucoma at baseline were included (baseline examination from 1991 to 1993; follow-up examinations from 1997 to 1999 and from 2002 to 2006). Ophthalmic examinations, including measurement of the intraocular pressure, assessment of the optic nerve head and perimetry, were performed at baseline and follow-up. The use of corticosteroids was monitored continuously during follow-up. Corticosteroids were stratified into five groups: ophthalmic steroids, inhaled steroids, nasal steroids, oral steroids and steroid ointments. Associations between the use of corticosteroids and incident OAG were assessed using logistic regression models. The study outcome measures were the odds ratios (ORs) of associations between the use of corticosteroids and incident OAG.

Results

During a mean follow-up of 9.8 years, 108 participants (2.8 %) developed OAG. The median number of steroid prescriptions during follow-up was 2 for ophthalmic, 7 for inhaled, 2 for nasal and 2 for oral steroids, and 3 for steroid ointments. The OR of the use of ophthalmic steroids was 1.04 [95 % confidence interval (CI) 0.66, 1.65; p = 0.86], inhaled steroids 0.79 (95 % CI 0.42, 1.48; p = 0.46), nasal steroids 1.26 (95 % CI 0.74, 2.13; p = 0.40), oral steroids 1.03 (95 % CI 0.65, 1.64; p = 0.89) and steroid ointments 0.70 (95 % CI 0.47, 1.05; p = 0.086). These analyses were adjusted for age, sex, high myopia and family history of glaucoma. The small median numbers of prescriptions made it difficult to evaluate dose-response relationships.

Conclusion

None of the classes of steroids were associated with the incidence of OAG in this elderly population.

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Copyright information

© Springer International Publishing Switzerland 2012

Authors and Affiliations

  • Michael W. Marcus
    • 1
  • Rogier P. H. M. Müskens
    • 1
  • Wishal D. Ramdas
    • 2
    • 3
  • Roger C. W. Wolfs
    • 2
    • 3
  • Paulus T. V. M. De Jong
    • 2
    • 4
    • 5
  • Johannes R. Vingerling
    • 2
    • 3
  • Albert Hofman
    • 2
  • Bruno H. C. Stricker
    • 2
    • 6
    • 7
  • Nomdo M. Jansonius
    • 1
    • 2
  1. 1.Department of OphthalmologyUniversity of Groningen, University Medical Center GroningenGroningenThe Netherlands
  2. 2.Department of EpidemiologyErasmus Medical Center RotterdamRotterdamThe Netherlands
  3. 3.Department of OphthalmologyErasmus Medical CenterRotterdamThe Netherlands
  4. 4.Department of OphthalmogeneticsNetherlands Institute for NeuroscienceAmsterdamThe Netherlands
  5. 5.Department of OphthalmologyAcademic Medical CenterAmsterdamThe Netherlands
  6. 6.Department of Internal MedicineErasmus Medical CenterRotterdamThe Netherlands
  7. 7.Department of Medical InformaticsErasmus Medical CenterRotterdamThe Netherlands

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