BACKGROUND: Posterior subcapsular cataracts (PSCs) have been reported to occur in some asthmatic patients treated with inhaled steroids. METHODS: We studied the associations between the occurrence of PSCs and inhaled and oral steroid therapy in 48 adults in a cross-sectional survey by slit lamp. Accurate records of the patients' long-term usage of these drugs were available: 9.2 +/- 5.2 years for inhaled steroid and 9.1 +/- 9.3 years for prednisone (mean +/- SD). Their current inhaled steroid dosage averaged 1.46 +/- 0.85 mg/day (range, 0 to 3.2 mg/day). RESULTS: Twenty-seven percent of the group had PSCs. The occurrence of PSCs correlated with the current daily dose and duration of prednisone use (p = 0.002 and p = 0.01, respectively), but not with the dose or duration of inhaled steroid treatment. As judged by multiple logistic regression analysis, neither the particular inhaled steroid drug used, nor its daily dose or cumulative dose, nor the additional nonsteroidal risk factors for PSCs also present in some of these patients contributed significantly to their risk of developing PSCs. CONCLUSIONS: The findings do not exclude the possibility that inhaled steroid therapy might lead to PSCs if a person has an exceptionally high inherent susceptibility. However, in the asthmatic population at large, the risk appears negligible, even if high doses of inhaled steroid are administered.
BACKGROUND: Posterior subcapsular cataracts (PSCs) have been reported to occur in some asthmatic patients treated with inhaled steroids. METHODS: We studied the associations between the occurrence of PSCs and inhaled and oral steroid therapy in 48 adults in a cross-sectional survey by slit lamp. Accurate records of the patients' long-term usage of these drugs were available: 9.2 +/- 5.2 years for inhaled steroid and 9.1 +/- 9.3 years for prednisone (mean +/- SD). Their current inhaled steroid dosage averaged 1.46 +/- 0.85 mg/day (range, 0 to 3.2 mg/day). RESULTS: Twenty-seven percent of the group had PSCs. The occurrence of PSCs correlated with the current daily dose and duration of prednisone use (p = 0.002 and p = 0.01, respectively), but not with the dose or duration of inhaled steroid treatment. As judged by multiple logistic regression analysis, neither the particular inhaled steroid drug used, nor its daily dose or cumulative dose, nor the additional nonsteroidal risk factors for PSCs also present in some of these patients contributed significantly to their risk of developing PSCs. CONCLUSIONS: The findings do not exclude the possibility that inhaled steroid therapy might lead to PSCs if a person has an exceptionally high inherent susceptibility. However, in the asthmatic population at large, the risk appears negligible, even if high doses of inhaled steroid are administered.