J Korean Ophthalmol Soc.  2015 Jun;56(6):891-899. 10.3341/jkos.2015.56.6.891.

Intraocular Pressure Elevation after 0.7 mg Intravitreal Dexamethasone (Ozurdex(R)) Implantation: A One Year Follow-Up

• Park DH
• Ha SJ
• Lee SJ

• KMID: 2339154
• DOI: http://doi.org/10.3341/jkos.2015.56.6.891

Abstract

PURPOSE
To investigate the percentage and time of intraocular pressure (IOP) elevation and the factors influencing IOP elevation and treatment.
METHODS
Thirty patients (33 eyes) who received intravitreal dexamethasone implantation from July 2012 to December 2013 and followed up more than 1 year were evaluated by measuring Goldmann IOP and confirming changes in IOP. The definition of IOP elevation was IOP above 20 mm Hg or IOP increase greater than 6 mm Hg.
RESULTS
In 16 eyes (48.5%), IOP was elevated after intravitreal dexamethasone implantation. The first IOP elevation was mean 2.0 +/- 0.7 months. In 21 eyes which received intravitreal dexamethasone implantation more than twice, the mean intervals of implantation were 4.5 months. In steroid responders, IOP after dexamethasone implantation was significantly increased at 1, 2, 3, 6, and 7 months. IOP increase in the treated eye was significant at 1, 2, 3, 5, and 7 months after dexamethasone implantation.
CONCLUSIONS
After intravitreal dexamethasone implantation, IOP was highest at 2 months. Additionally, IOP was elevated in approximately half of the patients (48.5%). Although the intravitreal dexamethasone implantation is effective against various diseases which occur due to macular edema, thorough identification of suitable patients and frequent IOP control is necessary for long-term treatment.

Keyword

Dexamethasone; Intraocular pressure; Steroid responder

MeSH Terms

Dexamethasone*
Follow-Up Studies*
Humans
Intraocular Pressure*
Macular Edema
Dexamethasone

Figure

• 

  Figure 1. Mean intraocular pressure (IOP) of responder (n＝16) and Non responder group (n＝17) treated with intravitreal dexamethasone 0.7 mg implantation measured with Goldmann applanation tonometer during 12 months follow up. Bar is 95% confidence interval for the mean. * Statistical significant difference of mean IOP compared to non responder (p ≤ 0.05, Mann-Whitney U-test). Pre＝ Preoperative time.

• 

  Figure 2. Mean intraocular pressure (IOP) difference between treated with intravitreal dexamethasone 0.7 mg implantation and untreated eyes in responder group (n＝14) during 12 months follow up. Bar is 95% confidence interval for the mean of IOP difference. Pre ＝ Preoperative time. * Statistical significant difference (p ≤ 0.05, paired t-test).

• 

  Figure 3. Mean intraocular pressure (IOP) difference between treated and untreated eyes in nonresponder group (n＝13). Observation period 12 months. Bar is 95% confidence interval for the mean of IOP difference. Pre ＝ Preoperative time.

• 

  Figure 4. Mean increased intraocular pressure (IOP) from baseline IOP of responder (n＝16) and nonresponder group (n ＝17) treated with intravitreal dexamethasone 0.7 mg implantation measured with Goldmann applanation tonometer during 12 months follow up. Bar is 95% confidence interval for the mean. * Statistical significant difference of mean IOP compared to nonresponder (p ≤ 0.05, Mann-Whitney U-test).

• 

  Figure 5. Classification of treatments. IOP＝ intraocular pressure; VEGF = vascular endothelial growth factor. *Ozurdex®, Allergan, Irvine, CA, USA; †Avastin®, Genentech Inc., San Francisco, CA, USA.

Reference

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