Evaluation impact of long-term usage of inhaled Fluticasone propionate on ocular functions in children with asthma

ObjectiveAlthough systemic, topical, and periocular corticosteroid administration have long been associated with ocular side effects, there has been little evidence to suggest that long-term inhaled corticosteroids can cause ocular side effects. The aim of this study was to evaluate the effects of long term treatment inhaled fluticasone propionate spray usage the recommended dose on some ocular functions in pediatric patients with asthma.MethodsThe study group consisted of 266 prepubertal children with asthma who had used inhaled fluticasone propionate spray at 3–6 years intermittently. One hundred and sixty children who were newly diagnosed with asthma without any treatment made up the control group. Schirmer test results, central corneal thickness, visual acuity, intraocular pressure, cataract formation, keratometry and tear break-up time compared between study and control groups.ResultsThe ages of the 266 study patients (150 male) were between 7 and 11 years. The average age (±SEM) was 8.2 ± 1.7 years, and the mean (±SEM) a daily dose of 323 μg (range 250–450 μg) inhaled fluticasone propionate spray, with 865.2 ± 215 g total steroid use during treatment. Eye functions including cataract formation, corneal ectasia, ocular hypertension or glaucoma, and dry eye were not observed in any of the patients in the study group and were not correlated with total steroid dosage (t = 0.150, p = 0.384).ConclusionOur findings suggest that long-term intermittent treatment for 3–6 years with inhaled fluticasone propionate spray, as much as average 320 μg daily, in children with asthma seems to be safe for some eye functions.

Research highlights
► Inhaled corticosteroids are still the gold standard in long-term anti-inflammatory management of persistent asthma in children.
► Higher doses and longer duration of exposure to inhaled corticosteroids are not associated with an increased risk of ocular side effects.
► Regular monitoring for ocular side effects does not appear to be warranted in children with asthma being treated with medium-high dose inhaled Fluticasone propionate.