Effect of Inhaled Fluticasone Propionate on Retinal Nerve Fiber Layer Thickness in Asthmatic Children

Abstract

Corticosteroids are under suspicion of playing an important role in the development of retinopathy. We aimed to determine peripapillary retinal nerve fiber layer (RNFL) thinning by spectral-domain optical coherence tomography (OCT) in children being treated with inhaled fluticasone propionate due to asthma. Thirty-eight children diagnosed with allergic asthma (mean age 9.8 ± 2.8 years, age range 6-13 years) and 40 age-similar controls were enrolled in this study. All children with asthma were taking inhaled fluticasone propionate at a dosage of 250 µg or more per day for at least 1 year. The RNFL thickness measurements were performed using Cirrus HD spectral-domain OCT 400. Central subfield thickness, cube average thickness, and cube volume were also measured. Among the 38 children with asthma and 40 healthy subjects who completed follow-up, children with asthma had similar mean peripapillary RNFL thicknesses compared with control children. The mean central subfield thickness was significantly higher than that of controls (248.8 ± 23.4 vs 237.5 ± 23.5, p<0.037). There was a positive linear relationship between cube average thickness and eosinophil count with a Pearson correlation coefficient of 0.336 (p<0.039) and a negative correlation was found between central subfield thickness and disease duration (r = -0.385, p = 0.017) in children with asthma. Asthmatic children have similar peripapillary RNFL measurements compared to controls on spectral-domain OCT. Raised eosinophil counts in asthmatic children were found to be significantly associated with cube average thickness.