Associated factors for steroid-induced ocular hypertension in children with systemic lupus erythematosus

This retrospective study investigated clinical factors associated with steroid-induced ocular hypertension in 49 pediatric systemic lupus erythematosus patients (mean age: 128.80 ± 34.6 months; 39 female and 10 male). All subjects underwent a 2-month follow-up with pretreatment assessment of age, sex, axial length, and clinical characteristics, including weight, systemic lupus erythematosus disease activity index (SLEDAI) scores, and erythrocyte sedimentation rate (ESR). Post-treatment variables were collected at the end of the 2-month follow-up, included the development of central obesity, elevated low-density lipoprotein levels, administration of pulsed intravenous steroid therapy, and cumulative methylprednisolone dosage. Forty-nine eyes of 49 patients were enrolled. Sixteen (32%) patients were diagnosed with steroid-induced ocular hypertension. One random eye was enrolled for each subject to avoid statistical bias. Steroid-induced ocular hypertension occurred from 3 d to 3 weeks following systemic steroid administration. No statistically significant differences were observed in pretreatment demographics, clinical characteristics, cumulative methylprednisolone exposure, low-density lipoprotein elevation, or pulsed intravenous therapy between patients with and without ocular hypertension. Notably, steroid-induced central obesity is associated with ocular hypertension (OR = 7.909 [95% CI: 1.382–45.256]) while no one had central obesity before steroid administration. This association persisted after multivariable adjustment for age, sex, weight, axial length, and SLEDAI scores (OR = 11.632 [95% CI: 1.131–119.633]). These findings suggest that pediatric patients who develop central obesity within the first 2 months of systemic steroid administration should undergo close intraocular pressure monitoring to facilitate early detection and prevention of steroid-induced glaucoma.