Development of posterior subcapsular cataracts in asthmatic children.

Posterior subcapsular cataracts (PSCC) are known complications of systemic steroid therapy. Previous studies have not clearly identified the asthmatic children at risk for the development of PSCC. The possible factors associated with systemic steroid administration that may influence the development of PSCC in asthmatic children were evaluated: (1) duration of administered steroids, (2) dose, (3) number of steroid "bursts" in the preceding year, (4) degree of retardation of bone age, and (5) mode of administration (daily or alternate day) of steroids. Of the 40 asthmatic children requiring steroids, seven (17.5%) had PSCC. All of the children with PSCC had been receiving steroids on a daily or alternate-day basis for at least 2 years and all had markedly delayed bone age. Only one child with the concurrent occurrence of these two factors did not develop PSCC. None of the other risk factors considered could distinguish the group of patients with PSCC. It is concluded that asthmatic children receiving steroids for 2 years or longer and having markedly delayed bone age are at a greater risk for the development of PSCC.