Comparative ocular findings in children with steroid-sensitive vs. steroid‑resistant nephrotic syndrome

Al-Khafaji,Zainab Nadom Hamoodi; Ali,Shatha Hussain

doi:10.3892/wasj.2025.326

Comparative ocular findings in children with steroid-sensitive vs. steroid‑resistant nephrotic syndrome

Authors:
- Zainab Nadom Hamoodi Al-Khafaji
- Shatha Hussain Ali
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Affiliations: Department of Surgery, College of Medicine, Al-Mustansiriya University, 79V2+CGC, Baghdad, Iraq, Department of Pediatrics, College of Medicine, Al-Nahrain University, 98HF+2R, Baghdad, Iraq
Published online on: February 17, 2025 https://doi.org/10.3892/wasj.2025.326
Article Number: 38
Copyright : © Al-Khafaji et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].

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Abstract

Corticosteroids are the primary therapy for children with nephrotic syndrome (NS). The aim of the present study was to investigate the prevalence of ocular manifestations in patients with NS who had undergone prolonged treatments with steroids and to this prevalence in those with steroid-sensitive NS (SSNS) to those with steroid‑resistant NS (SRNS). For this purpose, the present cross‑sectional study enrolled 100 children with NS aged 2‑18 years who had been treated between 2022 and 2023. The results revealed that out of 100 nephrotic children, 75 children had SSNS and 25 children were steroid‑resistant. Systolic and diastolic pressures levels were significantly higher in patients with SRNS with a mean of 100.2±8.72 and 68.0±6.12, respectively. Frequent relapses were reported in 11 (14.7%) of the patients in the SSNS group. In comparison to the SSNS group, the patients with SRNS exhibited a substantially higher rate of bilateral increased intraocular pressure (IOP) (28 vs. 6.67%, P=0.009) and posterior subcapsular cataract (PSCC) (20 vs. 4%, P=0.022). The patients with SRNS had higher refractive errors than those with SSNS (44 vs. 118.7%, P=0.011). Esotropia and exotropia were less common, but of similar distribution. PSCC and refractive errors were significantly associated with older patients, with a mean age of 12.2±2.8 (P=0.002) and 10.3±3.8 years (P=0.001). Increased IOP (P<0.001) and PSCC (P=0.003) were associated with frequent relapses, while refractive errors were associated with a longer disease duration (P=0.004). Systolic pressure significantly increased in the three conditions. On the whole, the findings of the present study indicate that a considerable proportion of patients with NS are susceptible to corticosteroid‑related ocular complications. Nevertheless, it is important to take into account the possibility of ocular involvement that is not responsive to steroid treatment in children with SRNS.

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