목적: 스테로이드 전신요법을 받은 소아에서 합병백내장의 유병률과 임상양상, 수술치료 결과를 알아보고자 하였다. 대상과 방법: 1년 이상 전신 스테로이드 치료를 받고 있는 소아환자로 소아안과 진료를 받은 환아의 의무기록을 조사하고, 스테로이드 합병백내장으로 진단받은 환아의 약제 총 투여기간 및 용량, 진료 기간 중 시력 변화를 알아보았다. 백내장 수술을 받은 환아에 대해 수술 전후 시력을 알아보았다. 결과: 전신 스테로이드 장기 치료를 받은 환아 1,408명 중 합병백내장으로 진단받은 환아는 48명 92안(2.5%)으로 약제 사용기간과 총 투여량은 시력과 유의한 관계가 없었다(R2<0.1). 양안성 백내장이 44명 88안, 단안성이 4명 4안이었고, 형태는 후낭하백내장이 가장 많았다(84.8%). 수술 없이 경과만 관찰한 41명 81안은 초진과 최종 시력에 유의한 차이는 없었으며(p=1), 수술을 받은 7명 11안에서 뚜렷한 시력 호전을 보였다(p<0.01). 결론: 소아에서 전신 스테로이드 합병백내장의 유병률은 약 2.5%로, 약제 총 투여기간 및 용량은 시력과 관계없었고, 투약기간 중 유의한 시력변화는 없었으나, 수술을 받은 경우 뚜렷한 시력 호전을 보였다.

Purpose: To reveal the incidence and clinical manifestations of steroid-induced cataract, and to evaluate the visual outcome after cataract surgery in children. Methods: We reviewed the charts of the pediatric patients who had been receiving oral prednisolone for at least one year and had visited the ophthalmologic clinic between January 1991 and December 2006, and enrolled the patients who had been diagnosed as having steroid-induced cataracts. We investigated the total dose and duration of medication and compared the visual acuity (VA) at the initial visit with that of the last follow-up. We also compared the pre- and post-operative best corrected visual acuity of the patients who had undergone cataract operation. Results: Among the 1408 patients who had been treated with systemic steroids for over one year, lens opacities were found in 92 eyes (2.5%). The total duration and dose of medication were not significantly correlated with the VA (R2<0.1). The lens opacities were found bilaterally in 88 eyes (91.7%), and unilaterally in 4 eyes (8.3%). The posterior subcapsular opacities were the most frequent (84.8%). In 81 eyes who had not undergone surgery, there was no significant change of VA (p=1). The 11 eyes who had undergone cataract surgery showed significant increases in VA (p<0.01). Conclusions: The incidence of steroid-induced cataract in pediatric patients was 2.5%. The dose and duration of medication were not significantly correlated with the visual impairment. There was no significant change in VA during the follow-up. The surgical outcome of the cataract operation was favorable.

Purpose: To reveal the incidence and clinical manifestations of steroid-induced cataract, and to evaluate the visual outcome after cataract surgery in children. Methods: We reviewed the charts of the pediatric patients who had been receiving oral prednisolone for at least one year and had visited the ophthalmologic clinic between January 1991 and December 2006, and enrolled the patients who had been diagnosed as having steroid-induced cataracts. We investigated the total dose and duration of medication and compared the visual acuity (VA) at the initial visit with that of the last follow-up. We also compared the pre- and post-operative best corrected visual acuity of the patients who had undergone cataract operation. Results: Among the 1408 patients who had been treated with systemic steroids for over one year, lens opacities were found in 92 eyes (2.5%). The total duration and dose of medication were not significantly correlated with the VA (R2<0.1). The lens opacities were found bilaterally in 88 eyes (91.7%), and unilaterally in 4 eyes (8.3%). The posterior subcapsular opacities were the most frequent (84.8%). In 81 eyes who had not undergone surgery, there was no significant change of VA (p=1). The 11 eyes who had undergone cataract surgery showed significant increases in VA (p<0.01). Conclusions: The incidence of steroid-induced cataract in pediatric patients was 2.5%. The dose and duration of medication were not significantly correlated with the visual impairment. There was no significant change in VA during the follow-up. The surgical outcome of the cataract operation was favorable.