Risk of cataract among users of intranasal corticosteroids

Background: Oral corticosteroid users are at increased risk of cataract, bu t the risk among intranasal corticosteroids users is unknown. Objective: Our purpose was to describe the risk of cataract among users of intranasal steroids. Methods: A retrospective observational cohort study of cataract incidence w as conducted among users of oral and intranasal steroids identified from th e United Kingdom-based General Practice Research Database with a nested cas e-control analysis to control for confounding factors, The study population included 286,078 subjects aged less than 70 years old drawn from 350 gener al practices in England and Wales. Patients were classified as users of onl y intranasal corticosteroids, users of only oral corticosteroids, and nonus ers of either medication. Computerized medical records were used to identif y cases of cataract. Two hundred twenty-five cases were randomly selected f or validation against general practitioners' held referral and hospitalizat ion letters. Results: The incidence rate of cataract (1.0/1000 person-years) among users of intranasal corticosteroids was similar to the incidence rate among nonu sers. However, oral corticosteroid users were at higher risk of cataract (2 .2/1000 person-years). Approximately 70% of intranasal corticosteroid expos ure mas to beclomethasone dipropionate only; the event rate in this group w as similar to that in the unexposed group. Cataract risk did not increase w ith the number of prior prescriptions for intranasal corticosteroids. Conclusion: The use of intranasal corticosteroids was not associated with a n increased risk of cataracts in this study population.