ECEESPE2025 Poster Presentations Adrenal and Cardiovascular Endocrinology (169 abstracts)
Intraocular pressure and risk of glucocorticoid-induced ocular hypertension are increased in children with congenital adrenal hyperplasia
Kübra Yüksek Acinikli 1 , Özlem Ural Fatihoğlu 1,2 , Özlem Kayır Kurt 3 , Gözde Akın Kağızmanlı 1 , Özge Yıldırım Şalbaş 1 , Deniz Özalp Kızılay 3 , Gül Arıkan 2 , Damla Gökşen 3 , Korcan Demir 1 , Ece Böber 1 & Ayhan Abacı 1
1Dokuz Eylül Medical Faculty, Pediatric Endocrinology, izmir, Türkiye; 2Dokuz Eylül Medical Faculty, Pediatric ophtalmology, Izmir, Türkiye; 3Ege University Medical Faculty, Pediatric Endocrinology, Izmir, Türkiye
JOINT3006
Background: Children with classical congenital adrenal hyperplasia (CAH) require lifelong glucocorticoid (GC) treatment. An important side-effect of steroids is GC-induced ocular hypertension, which may cause irreversible blindness known as GC-induced glaucoma.
Aim: This study aimed to evaluate the intraocular pressure (IOP) and the risk of GC-induced ocular hypertension in pediatric patients with congenital adrenal hyperplasia (CAH), a condition requiring long-term GC therapy due to impaired adrenal steroid synthesis.
Method: The study included patients aged 4–21 years diagnosed with salt-wasting or simple virilizing CAH and receiving hydrocortisone therapy, along with age-matched healthy controls. Data including GC dosages, auxological parameters, and levels of serum androstenedione (AS) and 17-hydroxyprogesterone (17-OHP) over the past year for all patients. IOP was measured using an Icare tonometer, with intraocular hypertension defined as a peak IOP of ≥21 mmHg in either eye. IOP levels were compared among CAH patients based on hydrocortisone dosage (≥15 mg/m2/day as high dose; <15 mg/m2/day as maintenance dose).
Results: The median ages of CAH patients (n=26) and controls (n=45) were 12±5 and 11.5±2.9 years, respectively (P=0.63). No difference was observed between the groups in terms of age and gender (P=0.63, P=0.8, respectively). IOP levels were significantly higher in CAH patients (20±3 mmHg) compared to healthy controls (13.8±3 mmHg) (P<0.001). Fourteen of CAH patients (53%) had intraocular hypertension; among these, three were treated with dexametasone (daily doses were 0.25 mg, 0.375 mg, and 0.5 mg). Age, gender, mean 17-OHP and AS levels over the past year of patients with intraocular hypertension were similar with those of normotension subgroup. However, the change in BMI SDS over the past year was significantly higher in patients with intraocular hypertension (P=0.005). Median IOP levels were similar (P=0.5) between the high dose hydrocortisone (n=9) and maintenance dose (n=14) groups. The correlation analyses revealed no significant associations between IOP and age, disease duration, AS, or 17-OHP levels. However, a positive significant correlation was observed between BMI SDS change over last year and IOP (r=0.5, P=0.008).
Conclusion: In patients with CAH, systemic GC can cause increased IOP which indicates the need for IOP screening of these children. Increase in BMI can be an additional risk factor.
Keywords: CYP21A2; adrenocorticotropic hormone; androgens; glaucoma
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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