The hidden ophthalmic dangers of steroids in COVID-19 treatment: a case report.

IF 1.5 4区医学 Q2 PEDIATRICS

Translational pediatrics Pub Date : 2025-03-31 Epub Date: 2025-03-26 DOI:10.21037/tp-24-443

Zhehuan Zhang, Tianchen Wu, Wenwen Xu, Di Hu, Chenhao Yang

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Abstract

Background: Coronavirus disease 2019 (COVID-19) has been coexisted with us, and corticosteroids are now recommended for patients with severe COVID-19 respiratory failure. Steroid treatments may increase intraocular pressure (IOP) and steroid-induced glaucoma (SIG). This study reported a rapid IOP elevation in a COVID-19 pneumonia child treated with systemic steroids within 3 days. Steroid-induced ocular hypertension (SIOH) during pneumonia treatment has not been previously reported.

Case description: The 6-year-old Chinese girl was diagnosed with COVID-19 and presented with pulmonary exudative lesions. Intravenous steroid (methylprednisolone, 1 mg/kg/12 h) was administered to control the inflammatory reaction on the fourth day post-infection. The child complained of ocular pain in the left eye (OS) after 3 days of steroid application. A high IOP of 40 mmHg in the right eye (OD) and 60 mmHg (OS) was detected. Following the exclusion of elevated IOP secondary to COVID-19 infection, SIOH was considered as a potential etiology. The IOP was effectively controlled through prompt tapering of systemic steroids and the immediate initiation of IOP-lowering therapy, including intravenous mannitol and topical antiglaucoma medications.

Conclusions: Clinicians treating COVID-19 in hospitals should pay attention to SIOH or SIG risk, especially in pediatric patients.

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类固醇在COVID-19治疗中的眼部隐患：一份病例报告

背景：2019冠状病毒病（COVID-19）与我们共存，目前建议对COVID-19严重呼吸衰竭患者使用皮质类固醇。类固醇治疗可能增加眼压（IOP）和类固醇性青光眼（SIG）。该研究报告了一名接受全身类固醇治疗的COVID-19肺炎儿童在3天内眼压迅速升高。在肺炎治疗期间类固醇引起的高眼压（SIOH）以前没有报道。病例描述：一名6岁的中国女孩被诊断为COVID-19，并表现为肺部渗出性病变。感染后第4天静脉注射类固醇（甲基强的松龙，1 mg/kg/12 h）控制炎症反应。在类固醇应用3天后，儿童主诉左眼眼痛（OS）。右眼高眼压40 mmHg (OD)，高眼压60 mmHg （OS）。排除继发于COVID-19感染的IOP升高后，SIOH被认为是一个潜在的病因。通过及时减少全身性类固醇和立即开始降低眼压的治疗，包括静脉注射甘露醇和局部抗青光眼药物，眼压得到有效控制。结论：临床医生在医院治疗COVID-19时应重视SIOH或SIG风险，尤其是儿科患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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