Inhalers may increase glaucoma incidence

17 Jun 2002

Prolonged continuous use of high doses of inhaled steroids may increase the risk of glaucoma or ocular hypertension, according to an article in this week's issue ofThe Journal of The American Medical Association (JAMA).

Edeltraut Garbe, M.D., from the Royal Victoria Hospital, McGill University Health Centre, Montreal, Canada, and colleagues studied the relationship between theuse of inhaled and nasal steroids and glaucoma in 48,118 patients in the Quebec universal health insurance program for the elderly.

The authors write: "Both factors, high-dose administration and prolonged continuous duration of use, had to be present to elevate the risk. No significant increasewas observed in continuous users of low to medium dosesof inhaled steroids." High dose is defined as 1,500 micrograms (mcg) or moreof the inhaled steroid,flunisolide, or 1,600 mcg or more of the other inhaled steroids. The risk for glaucoma was 44 percent higher for those who used high doses of inhaled steroids forthree months or longer compared with nonusers. It has been estimated that in excess of eight million prescriptions were written worldwide for nasal steroids in 1993,according to the researchers.