ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

INCS Use for Rhinitis Not Associated with Cataracts, Intraocular Pressure

by Amy E. Hamaker • January 7, 2019

  • Tweet
  • Email
Print-Friendly Version

Does the use of intranasal corticosteroids (INCS) lead to increased intraocular pressure (IOP) above 20 mm Hg, glaucoma, or formation of posterior subcapsular cataracts in adult patients with rhinitis?

Bottom Line:
INCS use is not associated with a significant risk of elevating IOP or developing a posterior subcapsular cataract in patients with allergic rhinitis. Presence of glaucoma, however, is the real clinical adverse event of concern.

You Might Also Like

  • Intranasal Corticosteroid Not Recommended as Monotherapy for Acute Rhinosinusitis
  • Obstructive Sleep Apnea May Adversely Affect Eye Health
  • Is Middle Ear Pressure Affected by Continuous Positive Airway Pressure Use?
  • SCIT Effective for Asthma, Allergic Rhinitis
Explore This Issue
January 2019

Background: Although the safety and efficacy of INCS are well established, there remains a concern that its use can lead to systemic side effects as seen with oral steroid administration, including the risk of posterior subcapsular cataracts or open-angle glaucoma. There have been no meta-analyses conducted on ocular changes, and only a handful of review articles discuss the use of INCS and ocular changes.

Study design: Literature review of 10 randomized controlled trials.

Setting: Ovid MEDLINE, Embase, Scopus, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases.

Synopsis: Four of the studies were useable for meta-analysis. Overall, risk of bias ranged from low to unclear for the majority of the domains across the included studies, and the patient population included patients older than 18 years of age, except for two studies, which included adolescents. All patients had a diagnosis of rhinitis. There were no patients with preexisting glaucoma or with evidence of posterior subcapsular cataract formation prior to INCS use except for two patients in one study who had posterior subcapsular cataracts at baseline that were initially missed. There were only two studies that assessed ocular changes with first generation INCS (beclomethasone); the majority mentioned use of tonometry to assess IOPs, but the exact tools varied. The absolute increased incidence of elevated IOP in patients using INCS was 0.8%. The overall incidence of glaucoma was 0/2,837. The absolute increased incidence of patients developing a posterior subcapsular cataract while using INCS versus placebo was not significant. In the meta-analysis, there were no patients with preexisting glaucoma. In total, the overall sample size was 2,226 patients, with 1,587 receiving the study drug and 639 receiving a placebo. All studies shared a follow-up period at 52 weeks. The overall pooled relative risk of abnormally elevated IOP in those who received INCS was 2.24 compared to those who received placebo. This study is limited in its generalizability.

Citation: Valenzuela, CV, Liu JC, Vila PM, Simon L, Doering M, Lieu JEC. Intranasal corticosteroids do not lead to ocular changes: a systematic review and meta-analysis. Laryngoscope. Published September 19, 2018 online ahead of print. doi: 10.1002/lary.27209

Filed Under: Literature Reviews, Practice Focus, Rhinology, Rhinology Tagged With: Intraocular Pressure, rhinitisIssue: January 2019

You Might Also Like:

  • Intranasal Corticosteroid Not Recommended as Monotherapy for Acute Rhinosinusitis
  • Obstructive Sleep Apnea May Adversely Affect Eye Health
  • Is Middle Ear Pressure Affected by Continuous Positive Airway Pressure Use?
  • SCIT Effective for Asthma, Allergic Rhinitis

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • Weaning Patients Off of PPIs
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Podcasts Becoming More Popular Method of Education for Otolaryngologists
    • How to Embrace Optimism in the Midst of the COVID-19 Pandemic
    • Tips on How to Approach Conversations with Patients about the COVID-19 Vaccine
    • Steps You Should Take to Protect Your Voice and Hearing During Telemedicine Sessions
    • Routine Postoperative Adjunct Treatments Unnecessary for Idiopathic Cerebrospinal Fluid Leaks

Polls

Have you spoken with your patients about receiving the COVID-19 vaccine?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2021 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.