A Case of Steroid Glaucoma in a Child Treated with Systemic Steroid as Graft-Versus-Host Disease.

Eo, Doo Ri; Han, Jong Chul; Kee, Chang Won

doi:2016.57.3.518

J Korean Ophthalmol Soc > Volume 57(3); 2016 > Article

Case Report

Journal of the Korean Ophthalmological Society 2016;57(3):518-523.
DOI: https://doi.org/10.3341/jkos.2016.57.3.518 Published online March 15, 2016.

A Case of Steroid Glaucoma in a Child Treated with Systemic Steroid as Graft-Versus-Host Disease.

Doo Ri Eo, Jong Chul Han, Chang Won Kee

Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ckee@skku.edu

이식편대숙주반응으로 장기간 전신스테로이드 투여 후 발생한 소아 스테로이드 유발 녹내장 1예

어두리⋅한종철⋅기창원

성균관대학교 의과대학 삼성서울병원 안과학교실

Abstract

PURPOSE
To report a case of steroid-induced glaucoma in a child who was treated with systemic steroids for a long period due to graft-versus-host disease. CASE SUMMARY: A 10-year-old male was referred to our ophthalmologic clinic for examination of papilledema due to persistent headache and nausea. He was diagnosed as aplastic anemia 8 years prior and took approximately 4,000 mg of oral prednisolone for 8 years from April 2007 to April 2015 for treatment of lung graft-versus-host disease after hematopoietic stem cell transplantation. His best corrected visual acuity was 0.8 (decimal) in the right eye, 0.5 in the left eye and intraocular pressure (IOP) measured using a Goldmann applanation tonometer was 42 mm Hg in the right eye and 43 mm Hg in the left eye. His cup-to-disc ratio was 0.8 in the right eye and 0.7 in the left eye. Additionally, superior and inferior neuroretinal rim thinning was present in both eyes. Despite using IOP-lowering agents, IOP was not controlled. However, after trabeculectomy with mitomycin C in both eyes, IOP became normalized. CONCLUSIONS: In cases of pediatric patients treated with systemic steroids for a long period of time, regular observation is necessary to prevent IOP elevation and steroid-induced glaucoma.

Key Words: Oral prednisolone;Steroid-induced glaucoma;Systemic steroid