J Korean Ophthalmol Soc.  2016 Sep;57(9):1422-1429. 10.3341/jkos.2016.57.9.1422.

Risk Factors and Incidence of Elevated Intraocular Pressure after Dexamethasone Intravitreal Implant

• Lim HC
• Park SW
• Lee JE
• Kim SJ
• Lee JW

• KMID: 2351873
• DOI: http://doi.org/10.3341/jkos.2016.57.9.1422

Abstract

PURPOSE
To report the incidence of intraocular pressure (IOP) elevation and identify the risk factors of IOP elevation after intravitreal dexamethasone 0.7 mg (Ozurdex®, Allergan, Irvine, CA, USA) implant.
METHODS
A total of 86 eyes of 79 patients who underwent intravitreal dexamethasone implantation and who were followed for ≥ 3 months were included in the present study. IOP elevation was defined as a pressure > 21 mm Hg at some time during follow-up.
RESULTS
Twenty-nine eyes (33.7%) had an IOP > 21 mm Hg after dexamethasone intravitreal implant. The incidence of IOP elevation increased rapidly at 2-3 months after dexamethasone intravitreal implant. The Kaplan-Meier estimated incidence of IOP elevation was 25.6 ± 4.7% (mean ± standard error) at 81 days. Cox multivariate analysis showed the significant risk factors of IOP elevation to be age < 55 years (p = 0.045), baseline IOP ≥ 15 mm Hg (p < 0.001), and history of intraocular surgery (p = 0.039).
CONCLUSIONS
This study demonstrates the incidence of IOP elevation to be 33.7% and describes the risk factors associated with IOP elevation. Clinicians should be cautious regarding the possibility of IOP elevation after intravitreal dexamethasone implant, especially in the presence of identified risk factors.

Keyword

Intraocular pressure elevation; Intravitreal dexamethasone implant; Risk factor

MeSH Terms

Dexamethasone*
Follow-Up Studies
Humans
Incidence*
Intraocular Pressure*
Multivariate Analysis
Risk Factors*
Dexamethasone

Figure

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  Figure 1. The Kaplan-Meier cumulative incidence of elevated intraocular pressure (event) in 86 eyes that underwent intravitreal dexamethasone implant injection. Events occurred in 29 eyes and the last event was at 580 days after intravitreal dexamethasone implant injection.

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  Figure 2. The Kaplan-Meier cumulative incidence of elevated intraocular pressure after intravitreal dexamethasone implant injection, for each group of eyes: Group 1, eyes with age ≥ 55 years (dotted line); and Group 2, eyes with age < 55 years (solid line).

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  Figure 3. The Kaplan-Meier cumulative incidence of elevated intraocular pressure after intravitreal dexamethasone implant injection, for each group of eyes: Group 1, eyes with baseline intraocular pressure < 15 mm Hg (dotted line); and Group 2, eyes with baseline intraocular pressure ≥ 15 mm Hg (solid line).

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  Figure 4. The Kaplan-Meier cumulative incidence of elevated intraocular pressure after intravitreal dexamethasone implant injection, for each group of eyes: Group 1, eyes without previous intraocular surgery (dotted line); and Group 2, eyes with previous intraocular surgery (solid line).

Reference

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