Osteonecrosis of the femoral head and glaucoma caused by topical corticosteroid application

Kabata, Tamon; Shimanuki, Keito; Shimanuki, Kiichi; Tsuchiya, Hiroyuki

doi:10.3109/s10165-011-0473-0

Cited by 5 publications

(4 citation statements)

References 7 publications

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“…No cases reports of glaucoma or cataracts associated with high potency TCS applied to non-periorbital area were found (Table 1). [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Thus, the findings support the understanding that the application of appropriately prescribed TCS to areas other than periorbital skin is unlikely to result in ocular disease. 8 Of note, it is essential to educate patients about avoiding application of clobetasol to the face, as it can cause perioral dermatitis/ steroid rosacea.…”

supporting

confidence: 54%

Retrospective analysis of ocular adverse events with Clobetasol

Wang

Jorizzo

2022

Dermatologic Therapy

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Psoriasis is a chronic autoinflammatory skin disease that affects 2% of the population worldwide. 1,2 Psoriasis has various clinical manifestations, the most common one being plaque psoriasis. 1,2 When it is untreated, the complications include chronic pain, bleeding, pruritus, and depression. 3 The treatment of psoriasis is often determined by clinical severity of the lesions and the extent/percentage of the affected body surface. 3 For mild-to-moderate psoriasis, high potency topical corticosteroids (TCS), vitamin D analogues, and phototherapy

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supporting

confidence: 54%

Retrospective analysis of ocular adverse events with Clobetasol

Wang

Jorizzo

2022

Dermatologic Therapy

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“…19 Bilateral osteonecrosis of the femoral head and glaucoma were reported as adverse events associated with prolonged TCS use for atopic dermatitis. 17 It would therefore appear that it is possible to induce ocular complications from systemic use of TCS; however, only with prolonged use over large areas with potent TCS.…”

Section: Discussion Of Case Reports and Seriesmentioning

confidence: 99%

“…Table 1 summarises the main case reports and series identified in the literature search. [7][8][9][10][11][12][13][14][15][16][17][18][19][20] The main questions arising from this search include: (i) can the periorbital application of topical steroids induce glaucoma and cataracts and, if so, what quantities are required; (ii) are individuals with known ocular disease at risk of exacerbating their condition by using TCS and (iii) can topical steroids applied on other areas of the body lead to ocular complications?…”

Section: Introductionmentioning

confidence: 99%

Ocular side–effects of topical corticosteroids: what a dermatologist needs to know

Daniel

Orchard

2015

Aust J Dermatology

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Topical corticosteroids are used frequently in dermatology and atopic dermatitis without significant adverse effects. Though ocular diseases such as glaucoma and cataracts are known complications of systemic corticosteroids, the role of topical corticosteroids is limited to case reports. This review assesses the literature regarding topical steroids and their role in ocular diseases. There is evidence of harm to vision when potent topical corticosteroids are inappropriately used for prolonged periods to periorbital sites. There is no evidence to date that weak TCS to the face or potent TCS to areas other than the eyes results in ocular complications. Further research trials are required in this area.

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“…18 Prolonged steroid use produces a hyperlipidemic state in most patients and subsequently results in abnormal coagulopathy and bone marrow fat-cell packing, leading to microvascular occlusion and high intra-osseous pressure, all of which put them at risk for osteonecrosis. 19 Therefore, accumulating researchers postulate that a lipid-lowering agent may prevent the conditions associated with the development of osteonecrosis. As lipid-clearing agents, statin agents have been demonstrated to reverse the adverse effects of steroid treatment on lipid metabolism, thus reducing the severity and frequency of ONFH.…”

Section: Discussionmentioning

confidence: 99%

Pravastatin prevents steroid-induced osteonecrosis in rats by suppressing PPARγ expression and activating Wnt signaling pathway

Jiang

Zhang

et al. 2014

Exp Biol Med (Maywood)

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Steroid-induced osteonecrosis of the femoral head (steroid-induced ONFH) is characterized by increase of intraosseous pressure because of lipid metabolism disturbance such as elevation of adipogenesis and fat cell hypertrophy in the bone marrow, subsequently leading to disturbances of coagulation-fibrinolysis system in the femoral head and finally resulting in bone ischemia. Pravastatin has been demonstrated to be useful in preventing steroid-induced ONFH in animal models. However, its exact mechanisms acting on this disease have not been fully elucidated. To address this problem, steroid-induced ONFH rat model was constructed to evaluate the effects of pravastatin treatment on the osteonecrotic changes and repair processes. Then, Micro-CT-based micro-angiography was performed to assess the effects of pravastatin treatment on vascularization. In addition, serum lipid levels were detected by haematological examination. After that, the expression of peroxisome proliferator-activated receptor gamma (PPARγ), Wnt3a, low density lipoprotein receptor-related protein 5 (LRP5), β-catenin and runt-related transcription factor 2 (RUNX2) at both mRNA and protein levels were further detected by immunohistochemistry, real-time quantitative PCR, and Western blot analyses. The results, the ratio of empty lacuna, adipose tissue area, and adipocyte perimeter in the bone marrow were dramatically lower in the pravastatin treatment groups than in the model group (all P < 0.05). Moreover, by micro-CT quantification, pravastatin treatment dose-dependently increased vessel volume, vessel surface, percentage of vessel volume, and vessel thickness of the femoral heads of steroid-induced ONFH rats. Importantly, pravastatin treatment could prevent steroid-induced ONFH by suppressing the expression of PPARγ, and increasing the expression of Wnt3a, LRP5, β-catenin, and RUNX2, at both mRNA and protein levels, in the femoral heads of steroid-induced ONFH rats. In conclusion, Pravastatin may prevent steroid-induced ONFH by suppressing PPARγ expression and activating Wnt signaling pathway.

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Osteonecrosis of the femoral head and glaucoma caused by topical corticosteroid application

Cited by 5 publications

References 7 publications

Retrospective analysis of ocular adverse events with Clobetasol

Retrospective analysis of ocular adverse events with Clobetasol

Ocular side–effects of topical corticosteroids: what a dermatologist needs to know

Pravastatin prevents steroid-induced osteonecrosis in rats by suppressing PPARγ expression and activating Wnt signaling pathway

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