Year : 1983 | Volume
: 31 | Issue : 7 | Page : 844--846
Congenital cataract and maternal ingestion of corticosteroids
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All-India Institute of Medical Sciences, New Delhi, India
S K Angra
Dr. Rajendra Prasad Centrefor Ophthalmic Sciences, All-India Institute of Medical Sciences, New Delhi 110029
|How to cite this article:|
Angra S K. Congenital cataract and maternal ingestion of corticosteroids.Indian J Ophthalmol 1983;31:844-846
|How to cite this URL:|
Angra S K. Congenital cataract and maternal ingestion of corticosteroids. Indian J Ophthalmol [serial online] 1983 [cited 2021 Jun 13 ];31:844-846
Available from: https://www.ijo.in/text.asp?1983/31/7/844/29683
The association of the cataract with local and systemic cortico-steroids ingestion is well established. But association of congenital cataract with maternal corticosteriod ingestion has been reported only in one human case by Kraus.
An attempt has been made to present foul such cases of congenital cataract in infant with maternal ingestion of corticosteroids during pregnancy.
METHODS, MATERIALS AND OBSERVATIONS
Four infants have been brought with bilateral cataracts. There is a definite evidence of mothers having taking cortico steroids in antenatal period for various medical indications like asthma, colitis, Rheumatic problems etc
The morphological details of cataracts are described in [Table 1] [Figure 1][Figure 2][Figure 3][Figure 4].
All laboratory examinations for evidence of any metabolic disease were completely negative. Rubella aetiology and genetic aetiology have also been excluded in these cases.
Our documentation of association of congenital cataract and maternal ingestion of corticosteroid gives clinical support to the observations of Krause who has described one such case.
The transplacental passage of corticosteriods has been demonstrated (Beitins 1972). Rogoyski et al has also shown that there is relatively high incidence of cataract in mouse foetus when injections of Hydrocortisone were given to mother mouse. There was statistically significant correlation between the number of congenital abnormalities and cataract in foetus and stage of gestation at which corticosteriods has been administered to pregnant mice. This supports the terratogenic effects of corticosteriods. But in our cases besides cataract, one case showed low degree of microphthalmos. No other congenital abnormality has been seen in our cases.
The cataracts noticed by us were bilateral and complete in three cases. One case had nuclear cataract which was similar to that reported by Krause. There was good amount of hydration and lenticular fibre swellings to allow us to complete simultaneous Aspiration Irrigation in single stage in our cases. In comparison to this, the corticosteroid induced cataract in adults cases on corticosteroid ingestion is posterior subcapsular and show iridescence, which was not present in our cases.
The mechanism of cataract formation in foetus is not clear. Based on the fact that corticosteroids effect the transport of water and increase the permeability of lens membranes to cations, and the morphology of the cataracts we have observed, we feel it is osmotic type of mechanism which operates in congenital cataracts with maternal conticosteroids ingestion.
Congenital cataracts with maternal ingestion of corticosteroids has been described in four cases.
|1||Kraus, A, 1975, J. Ped. Ophthalmol. 12:107.|
|2||Beitins E.E., 1972, J. Pediatr. 81, 935.|
|3||Rogoyski, A and Trzcinska- Dabrowska Z., 1969. Amer J. Ophthalmol. 68:128.|