ผลกระทบของการใช้ยาสเตียรอยด์แบบพ่นจมูกที่มีต่อการเพิ่มความดันลูกตาในโรงพยาบาลบ้านโป่ง

Theerapat  Benjasil

Authors

Theerapat Benjasil M.D., Banpong Hospital

Keywords:

intranasal steroids, intraocular pressure, fluticasone furoate, budesonide

Abstract

Objective: The purpose is to study the effect of intranasal steroids on intraocular pressure and compare outcome on intraocular pressure between budesonide and fluticasone furoate in allergic rhinitis in Banpong Hospital.

Methods: A randomized prospective cohort study was conducted in 62 patients at Banpong Hospital from June to December 2023. The age was between 18–70 years. The patients were diagnosed as allergic rhinitis with moderate to severe and persistent symptoms, and used intranasal steroids (fluticasone furoate or budesonide). Patients who had increased intraocular pressures (> 21 mmHg); underlying cataracts or glaucoma; diabetes mellitus and hypertension; and history uses of oral, injection, inhaled, and topical steroid and pseudoephedrine were excluded from this study. The intraocular pressure was measured by non contact tonometer before treatment and repeated at one, three, and six months after treatment between budesonide and fluticasone furoate. Repeated measures ANOVA intraocular pressure before and after use intranasal steroids and two-way repeated measures ANOVA were used to analyze compare intraocular pressure between the drugs.

Results: The mean intraocular pressure was 14.15 ± 2.27 mmHg for before budesonide treatment; and 14.47 ± 2.88 mmHg, 14.53 ± 2.77 mmHg, and 14.26 ± 2.39 mmHg for 1 month, 3 months, and 6 months of budesonide treatment respectively. The mean intraocular pressure was 14.75 ± 2.67 mmHg before fluticasone fluroate treatment; and 14.27 ± 2.39 mmHg, 14.37 ± 2.29 mmHg, and 14.65 ± 2.39 mmHg for 1 month, 3 months, and 6 months of fluticasone furoate treatment. The repeated measures ANOVA showed no statistically significant difference between the pre- and post-steroid use intraocular pressures at all three treatment periods (1 month, 3 months, and 6 months) in fluticasone furoate group and budesonide group (p = .974, p = .640). Additionally, there was no statistically significant difference in intraocular pressure between the drugs (p = .495).

Conclusion: Intraocular pressure after 6-month continuously using intranasal steroid does not significantly elevate and intraocular pressure is not different between budesonide and fluticasone furoate. Then intranasal steroid can be safe after prolonged used.

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