Akademik Veri Yönetim Sistemi
50th Annual Meeting European Paediatric Ophthalmology Society, Leiden, Hollanda, 9 - 11 Ekim 2025, ss.67, (Özet Bildiri)
Introduction: Children with classical congenital adrenal hyperplasia (CAH) require lifelong systemic glucocorticoid (GC) therapy. A significant but often underrecognized side effect is GC-induced intraocular pressure (IOP) elevation, which may lead to irreversible glaucomatous damage if undetected. This study aimed to assess IOP and the incidence of ocular hypertension in pediatric CAH patients under GC therapy. Methods: A cross-sectional analysis was performed on 26 CAH patients (aged 4–21 years) receiving hydrocortisone and 45 age- and sex-matched healthy controls. Ocular examinations, including IOP measurement via Icare tonometry, were conducted. Intraocular hypertension was defined as a peak IOP ≥21 mmHg. Data collected for patients included GC dosages, auxological parameters, and serum levels of androstenedione and 17- hydroxyprogesterone over the past year. IOP levels were compared between patients on high-dose (≥15 mg/m²/day) and maintenance-dose (<15 mg/m²/day) hydrocortisone. Results: IOP was significantly higher in CAH patients than in controls (20 ± 3 mmHg vs. 13.8 ± 3 mmHg, p<0.001). Intraocular hypertension was detected in 53% of CAH patients. IOP was unrelated to age, sex, or hormonal control but correlated positively with BMI SDS changes over the past year (r=0.5, p=0.008). No significant difference in IOP was found between high- and maintenance-dose groups (p=0.5). Conclusion: Elevated IOP is a significant complication in children with CAH receiving systemic GC therapy, even with physiological hydrocortisone doses adjusted to circadian rhythm, indicating an intrinsic ocular vulnerability. These findings emphasize the need for regular IOP monitoring, particularly in patients with BMI SDS increase, and interdisciplinary follow-up to prevent glaucomatous damage.