Paper Information

To assess the association of cataract progression and intraocular pressure (IOP) elevation with stable-dosing of topical corticosteroid for chronic anterior uveitis (CAU).

For the incident cataract outcome, 346 patients met the eligibility criteria. Based on differing eligibility criteria, fewer patients were enrolled for the IOP events (n = 260 and 282 for ≥21 and ≥30 mmHg, respectively). In general, the incidence of cataract formation increased with increasing daily drops of stable-dosing of topical corticosteroid; however, there was no excess risk (relative to zero drops) for eyes exposed to ≤1 drop daily of prednisolone 1% or equivalent [aHR, 0.91 (95% CI, 0.29, 2.84)]. Similarly, higher daily topical corticosteroid exposure conferred greater risk of both IOP outcomes, though plateau effects were observed. For eyes receiving ≤1 drop daily of prednisolone 1% or equivalent, there was no excess risk of either IOP outcome [aHR for ≥21 mmHg, 0.77 (95% CI, 0.19, 3.05) and aHR for ≥30 mmHg, 0.92 (95% CI, 0.11, 7.76)].

All patients with CAU from the Systemic Immunosuppressive Therapy for Eye Diseases Cohort treated with topical prednisolone 1% or equipotent equivalent for at least six months were analyzed. Main outcomes were incident cataract formation and IOP elevation above predefined thresholds (≥21 mmHg and ≥30 mmHg). Additional variables with potential to influence the frequency of the main outcomes were also collected.

Stable-dosing of topical prednisolone 1% or equivalent more than once daily was associated with increased cataract formation and IOP elevation over medium-term follow-up, whereas ≤1 drop/day was not.