Systemic toxicity of topical and periocular corticosteroid therapy in an 11-year-old male with posterior uveitis

Am J Ophthalmol. 2000 Aug;130(2):240-1. doi: 10.1016/s0002-9394(00)00501-8.

Abstract

Purpose: To report a case of systemic corticosteroid toxicity resulting from topical and periocular therapy.

Methods: Treatment and follow-up of an 11-year-old male with uveitis are illustrated. Initial presentation of the patient was bilateral iridocyclitis, for which he was treated with prednisolone acetate 1% every 2 hours for 6 months. Subsequently, posterior uveitis developed, necessitating posterior subtenon injections.

Results: After initial topical corticosteroid therapy, the patient developed a cushingoid habitus accompanied by increased lanugo hair, acanthosis nigricans, posterior subcapsular lens opacities, and increased intraocular pressure. Cushingoid stigmata worsened after administration of posterior subtenon injection of corticosteroids. The patient's truncal obesity worsened, and his linear growth stopped.

Conclusions: Systemic toxic effects may develop as a result of topical and local use of ophthalmic corticosteroid preparations in susceptible patients.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acanthosis Nigricans / chemically induced*
  • Administration, Topical
  • Anti-Inflammatory Agents / adverse effects*
  • Anti-Inflammatory Agents / therapeutic use
  • Cataract / chemically induced*
  • Child
  • Cushing Syndrome / chemically induced*
  • Glucocorticoids
  • Growth Disorders / chemically induced
  • Hair Diseases / chemically induced
  • Humans
  • Injections
  • Intraocular Pressure / drug effects
  • Iridocyclitis / drug therapy
  • Lens, Crystalline / drug effects
  • Male
  • Methylprednisolone / adverse effects*
  • Methylprednisolone / analogs & derivatives*
  • Methylprednisolone Acetate
  • Obesity / chemically induced
  • Ocular Hypertension / chemically induced*
  • Ocular Hypertension / drug therapy
  • Prednisolone / adverse effects*
  • Prednisolone / analogs & derivatives*
  • Prednisolone / therapeutic use
  • Uveitis, Posterior / chemically induced*

Substances

  • Anti-Inflammatory Agents
  • Glucocorticoids
  • Methylprednisolone Acetate
  • prednisolone acetate
  • Prednisolone
  • Methylprednisolone