Ocular complications of paediatric patients with nephrotic syndrome

Clin Exp Ophthalmol. 2001 Aug;29(4):239-43. doi: 10.1046/j.1442-9071.2001.00426.x.


Purpose: To investigate ocular complications arising from nephrotic syndrome and/or its treatments in children.

Methods: A cross-sectional study was conducted in a teaching hospital. A total of 31 paediatric patients with nephrotic syndrome were studied. Comprehensive ophthalmic assessments on best-corrected visual acuity, intraocular pressure, slit-lamp and fundus examination were taken. Information regarding histological diagnosis of nephrotic syndrome and its treatment regimen in each patient was reviewed and analysed.

Results: Bilateral posterior subcapsular cataracts were detected in three of 29 patients (10.3%) who received steroid therapy. Two had normal vision while one had visual acuity reduced to 6/15 in both eyes. The age of onset of the nephrotic syndrome in these three patients was 2 years, which was significantly younger than those without cataract (5.4 +/- 3.2 years, P < 0.001). Three patients (9.7%) had isolated asymptomatic fundal findings of tortuous and dilated retinal vessels. Hypertensive retinopathy was found in one patient (3.2%). No steroid-induced glaucoma, uveitis, ocular infection, or other eye complications related to the use of steroids or other immunosuppressive agents were noted.

Conclusions: Children who have nephrotic syndrome often require prolonged, intermittent high dose of systemic corticosteroid therapy. Paediatricians should be aware of the potential risk of developing steroid-related complications, especially posterior subcapsular cataract. It appears to have a higher risk when steroid therapy is used in very young patients. Early detection would help to prevent amblyopia development, particularly in the group of immature eyes.

MeSH terms

  • Adolescent
  • Cataract / chemically induced
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Eye Diseases / etiology*
  • Female
  • Glucocorticoids / adverse effects
  • Humans
  • Lens, Crystalline / drug effects
  • Male
  • Nephrotic Syndrome / complications*
  • Ocular Hypertension / etiology
  • Prednisolone / adverse effects
  • Retinal Diseases / etiology
  • Retinal Vessels / pathology
  • Risk Factors


  • Glucocorticoids
  • Prednisolone