Effect of inhaled fluticasone propionate on retinal nerve fiber layer thickness in asthmatic children

Purpose: Corticosteroids are under suspicion of playing an important role in the development of retinopathy. We aimed to determine peripapillary retinal nerve fiber layer (RNFL) thinning by spectral-domain optical coherence tomography (OCT) in children being treated with inhaled fluticasone propionate due to asthma. Methods: Thirty-eight children diagnosed with allergic asthma (mean age 9.8 +/- 2.8 years, age range 6-13 years) and 40 age-similar controls were enrolled in this study. All children with asthma were taking inhaled fluticasone propionate at a dosage of 250 mu g or more per day for at least 1 year. The RNFL thickness measurements were performed using Cirrus HD spectral-domain OCT 400. Central subfield thickness, cube average thickness, and cube volume were also measured. Results: Among the 38 children with asthma and 40 healthy subjects who completed follow-up, children with asthma had similar mean peripapillary RNFL thicknesses compared with control children. The mean central subfield thickness was significantly higher than that of controls (248.8 +/- 23.4 vs 237.5 +/- 23.5, p<0.037). There was a positive linear relationship between cube average thickness and eosinophil count with a Pearson correlation coefficient of 0.336 (p<0.039) and a negative correlation was found between central subfield thickness and disease duration (r = -0.385, p = 0.017) in children with asthma. Conclusions: Asthmatic children have similar peripapillary RNFL measurements compared to controls on spectral-domain OCT. Raised eosinophil counts in asthmatic children were found to be significantly associated with cube average thickness.