Correlation Between Posterior Subcapsular Cataract and Long-Term Topical Corticosteroid Use in Patients with Dermatological Conditions

Background: It is well known that corticosteroid therapy can lead to ocular complications such as posterior subcapsular cataract (PSC). Topical corticosteroids are commonly utilized by dermatologists; however, there are few data available that can inform an association with PSC. A retrospective, observational study using a large, anonymous, independent centralized database was carried out. Methods: This was a retrospective, observational study with the use of a large, anonymous, independent centralized database. Material and Methods: This cross-sectional analytical study was conducted at the hospital and comprised 140 patients who were being treated with topical corticosteroid for at least six months. Information regarding demographic data, dermatological diagnosis, corticosteroid potency, duration of treatment and the site where it has been applied were taken. All of them had complete ophthalmological evaluation with slit-lamp biomicroscopy with PSC detection and grading. Data were analysed using SPSS (version 25.0) and a p-value of <0.05 was taken to be statistically significant. Results: The mean age of participants was 42.8±11.6 years, and females constituted 55.7% of the study population. Posterior subcapsular cataract was identified in 42 (30.0%) patients. PSC prevalence increased significantly with longer duration of topical corticosteroid use (p<0.001) and was higher among patients using potent and very potent corticosteroids (p=0.012). Multivariate logistic regression demonstrated that corticosteroid therapy exceeding three years (AOR 3.86, 95% CI 1.84–8.09), potent/very potent corticosteroid use (AOR 2.74, 95% CI 1.29–5.81), age above 40 years (AOR 2.14, 95% CI 1.09–4.21), and facial/periorbital application (AOR 2.32, 95% CI 1.07–5.04) were independent predictors of PSC. Conclusion: Long-term topical corticosteroid therapy is significantly associated with posterior subcapsular cataract, particularly with prolonged use of high-potency preparations. Regular ophthalmological screening, careful corticosteroid selection, and patient education are recommended to reduce steroid-related ocular complications.

Keywords: Posterior subcapsular cataract, topical corticosteroids, dermatological disorders, atopic dermatitis, ocular complications, corticosteroid-induced cataract.