Journal of Ophthalmology · 2 authors, 2 centres
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This systematic review and meta-analysis of 19 observational studies found that inhaled corticosteroid (ICS) treatment approximately doubles the risk of cataract in asthma and COPD patients, with a dose-response relationship showing increased risk at daily ICS doses ≥1000 μg.
A systematic review following PRISMA guidelines included 19 observational studies, of which 12 provided effect estimates for pooled meta-analyses using a random effects model. Meta-regression assessed dose-response relationships between corticosteroid exposure and cataract risk. Pooled analyses revealed on average a doubled risk of cataract in corticosteroid-exposed asthma and COPD patients. Eight studies reported increased cataract risk in ICS-treated patients. Daily high-dose ICS of at least 1000 μg was associated with significant cataract risk. One study found systemic corticosteroids increase cataract risk more than ICS. Key limitations include that studies were observational (precluding causal inference), heterogeneity in cataract detection methods and variable adjustments across analyses, and funnel plot asymmetry that could not rule out publication bias. Most included studies were rated as high quality.
