Cataract formation in DMD patients on long-term glucocorticoid therapy

The medical records of Duchenne muscular dystrophy (DMD) patients on long-term glucocorticoid therapy (GC) treatment were reviewed retrospectively to evaluate the development of cataracts or ocular hypertension in patients. The main outcome measures were prevalence of cataracts and ocular hypertension, age of first detection of cataract, time from initial steroid use to first detection of cataract, and relative risk of cataract development for deflazacort versus prednisone treatment. Of 596 DMD patients, 514 underwent GC therapy. The prevalence of cataracts was 22.4% in patients on GC therapy. The mean age at which cataract formation was first documented was 12.9 ± 4.1 years (IQR, 9.6-14.6). The mean time from initial steroid use to the first detection of cataract was 6.5 ± 3.6 years (IQR, 4.0-8.6). The odds of cataract development were 2.4-fold higher for patients on deflazacort compared with prednisone (95% CI, 1.3-4.5; P = 0.004). Only 7 patients (1.4%) underwent cataract surgery, at a mean age of 16.9 years (range, 10.7-24.6 years); all were on deflazacort. Among patients with available intraocular pressure measurements, ocular hypertension occurred in only 1 patient (1.1%), who was on deflazacort.

Rice ML, Wong B, Horn PS, Yang MB. Cataract development associated with long-term glucocorticoid therapy in Duchenne muscular dystrophy patients. JAAPOS. 2018 Jun;22(3):192-196.