Descriptive analysis of changes in intraocular pressure associated with glucocorticoid therapy for children with hematological malignancies: a retrospective study

Background Children with hematological tumors receiving prolonged glucocorticoid therapy are at risk of developing increased intraocular pressure (IOP) and hormone-induced glaucoma. Here, we aimed to analyze the trends of IOP changes and their correlation with drug usage, which are crucial for improving prevention and treatment strategies. Methods A retrospective analysis was conducted on children with lymphoblastic leukemia or lymphoma who received glucocorticoids (prednisone acetate, 60 mg/m²) for > 2 weeks at Peking University First Hospital between April 2019 and October 2022. General data, IOP measurements, IOP-lowering drug usage, and concomitant medications were collected. Descriptive analysis was performed to identify factors influencing IOP elevation during glucocorticoid therapy. Results Of 36 eligible children, 29 (80.56%) experienced increased IOP, and 4 (13.79%) exhibited clinical symptoms attributable to elevated IOP. A significant positive correlation was found between the timing of IOP increase and cumulative prednisone dose at that time. A negative correlation was observed between the duration of IOP elevation and the timing of the earliest IOP increase. All children with elevated IOP received IOP-lowering drugs under ophthalmologic supervision, with 13 (44.8%) requiring multiple medications, resulting in normalization of IOP. Conclusions Prolonged glucocorticoid use in children with hematological tumors was associated with a high incidence of IOP elevation. The duration of IOP increase was positively correlated with cumulative prednisone dose and negatively correlated with the timing of onset. Active intervention with IOP-lowering medications effectively reduced IOP to normal levels.