Prevalence Of Ocular Side Effects Of Deflazacort Treatment In Duchenne Muscular Dystrophy, A One Year Hospital Based Cross-Sectional Study

Abstract

Background & Objectives – Duchenne muscular dystrophy (DMD) is the most common hereditary neuromuscular disease with an incidence of 1 in 3,600 live born infant boys. Corticosteriods form the mainstay in the medical management of this disease , initially prednisolone was used but due to a large number of systemic and ocular side effects Deflazacort treatment was initialted. Deflazacort is a third generation of corticosteriod and not much is researched from ophthalmic point of view. The prevalence and association of ocular side effects in these patients was the mainstay of the study Methods - Cross sectional one year study was conducted in JNMC, Belagavi. 50 diagnosed patients with Duchenne muscular dystrophy were taken up for the study using 0.9 mg/kg of Deflazacort on daily basis and a complete ocular examination was performed along with intraocular pressure. The different findings were associated with the age and duration of treatment with Deflazacort using SPSS software for its statistical analysis. Results –A a total of 50 patients were tabulated, The mean age of the patients were 8.78 years & the mean age of diagnosis of DMD is 7 years . Thirty two percent (16/50) had cataract (Posterior subcapsular cataract ) in both eyes. One – ten months on treatment 16 (32%) patients , 11- 20 months is 15 patients (30%) and beyond 21 months is 19 patients (32.21%) had Posterior subcapsular cataract. The average intraocular pressure in both eyes is 13.2 and 14.01 mm of mercury respectively. Conclusion :- Evaluating the ocular side effects of Deflazacort in patients diagnosed with Duchenne muscular dystrophy (DMD) and we found very strong association of the incidence of cataract (PSC) with the consumption of this drug . Deflazacort keeps the patients intraocular pressure within normal limits and reduces the incidence of glaucoma induced by corticosteroids as compared to Prednisolone. The presence of cataract causes visual debilitation in the patients. Hence there is a need for surgical intervention to restore the vision. In the future the patients will progressively lose vision and will need more vigilant ophthalmic follow ups.