Effect Of Long-term Use Of Corticosteroids On The Cataract And High Intraocular Pressure In Patients With Duchenne Muscular Dystrophy And Family Status Survey

ObjectiveDuchenne muscular dystrophy(DMD)is a progressive and fatal X-linked recessive genetic neuromuscular disease that mainly affects male patients.1、To analyze the effects of long-term use of corticosteroids on high intraocular pressure and cataract and related risk factors in patients with Duchenne muscular dystrophy(DMD).2 、 Duchenne muscular dystrophy(DMD)is a hereditary myopathy that seriously affects exercise performance.There is no cure for duchenne muscular dystrophy(DMD).Family care is one of the main factors affecting the quality of life of patients.We investigated the family status of a group of DMD patients in China,in order to improve the quality of life of patients in the future.Methods1、The data of 158 DMD patients with detailed eye examinations in the DMD Multidisciplinary Outpatient Clinic of the Third Medical Center of the PLA General Hospital from August 2018 to December 2020 were retrospectively analyzed.Regarding whether or not to take corticosteroids for a long time(≥6months),the patients were divided into corticosteroids group(n=103 cases)and corticosteroids free group(n=31 cases),and 24 cases taking corticosteroids less than 6 months were not included in this study.Incidence of cataract and high intraocular pressure were compared.Logistic regression was used to explore the correlation between cataract and high intraocular pressure and age,medication time,type of corticosteroids,BMI,DP260 and DP71,respectively.2 、 Design the "DMD Children’s Family Situation Questionnaire",which mainly included: family structure,parents’ educational level,main caregivers,and family income.336 parents of DMD patients completed the above-mentioned questionnaire and analyzed the collected data.Results1、In the corticosteroids free group,1 case with intraocular pressure was reported,and no cataract was revealed.In the corticosteroids group,there were 13 cases(12.6%)with cataracts and 24 cases(23.3%)with high intraocular pressure,1case because of cataract was treated with surgery.Long-term use of corticosteroids was more likely to cause cataracts or high intraocular pressure(P<0.01).The incidence of cataract and high intraocular pressure was 27.3%(3/11)and 27.3%(3/11)in the deflaxacort group(n=11),respectively,and 10.9%(10/92)and 22.8%(21/92)in the prednisone group,respectively.As indicated by logistic regression,cataract was related to the type of corticosteroids and the duration of corticosteroid use.Moreover,there was no significant correlation between high intraocular pressure and age,time of medication,type of hormones taken,BMI,DP260,and DP71.2 、In this group of DMD families,67.9% of them lived in the county town or countryside.71% of DMD boys were from multi-generational families,and about 70% of the parents of DMD patients had an educational level below college.Although 47.6% of DMD patients’ primary caregivers were mothers,and 16.4% were grandparents.About 65.5% of DMD families had a monthly income of less than 5000 yuan,and 15.2% of DMD families had family income that could not meet the family expenditure.Conclusions1、DMD patients have a higher incidence of cataracts and high intraocular pressure after long-term use of corticosteroids.The type of corticosteroid taken and the time are independent risk factors for cataracts.Besides,the longer duration of take corticosteroid,the more lead to cataracts with take deflazacort.2、Compared with normal children of the same age,there were specificities of DMD patients’ family structure,their parents’ education level,primary caregivers,and family economic conditions.We need to focus and give a hand when formulating DMD care strategies to help them cope with difficulties.