Does prednisone (corticosteroid) exacerbate age-related macular degeneration?

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From the Research

Prednisone does not typically worsen macular degeneration, and in some cases, it may actually be prescribed to treat certain inflammatory conditions that affect the eye. Prednisone is a corticosteroid medication that reduces inflammation throughout the body. For patients with macular degeneration, especially the "wet" form that involves abnormal blood vessel growth and inflammation, short-term corticosteroid use might be beneficial rather than harmful, as seen in a study where patients treated with corticosteroids had peripheral visual field improvements from 10 to 25 degrees and central field improvements from 5 to 20% 1. However, long-term use of prednisone can potentially cause other eye problems such as cataracts or increased intraocular pressure that could lead to glaucoma, as discussed in a review of corticosteroids in ophthalmology 2. These side effects are generally associated with prolonged use at higher doses (typically above 10mg daily for months). If you have macular degeneration and need prednisone for another condition, your doctor will weigh the benefits against potential risks. Regular eye examinations are important for anyone taking prednisone long-term, especially those with pre-existing eye conditions. Some studies have also explored the use of antioxidant vitamin and mineral supplements in slowing the progression of age-related macular degeneration, with moderate-certainty evidence suggesting that antioxidant vitamin and mineral supplementation probably slows down progression to late AMD 3. However, the most recent and highest quality study on this topic is from 2023, which found that people taking antioxidant vitamins were less likely to progress to late AMD (odds ratio 0.72,95% confidence interval 0.58 to 0.90) 3. In terms of specific recommendations, the use of prednisone in patients with macular degeneration should be carefully considered, taking into account the potential benefits and risks, and regular eye examinations are crucial to monitor for any changes in vision. Key points to consider:

  • Prednisone may be beneficial for short-term use in patients with inflammatory conditions affecting the eye
  • Long-term use of prednisone can cause eye problems such as cataracts or increased intraocular pressure
  • Antioxidant vitamin and mineral supplements may slow down progression to late AMD
  • Regular eye examinations are important for anyone taking prednisone long-term, especially those with pre-existing eye conditions.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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