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Anna Sala-Puigdollers, Javier Zarranz-Ventura, Jessica Matas, Marina Mesquida, Victor Llorens, Blanca Molins, Maria Socorro Alforja, Juan Giralt, Maite Sainz De La Maza, Alfredo Adan Civera; Intraocular pressure changes after repeat intravitreal dexamethasone implant injections in retinal vein occlusions, uveitis and diabetic macular edema. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2673.
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© ARVO (1962-2015); The Authors (2016-present)
To address the effect in intraocular pressure (IOP) of repeat intravitreal dexamethasone implant (IDI, Ozurdexâ) injections in retinal vein occlusions (RVO), uveitis (UV) and diabetic macular edema (DME).
Retrospective, single-center cohort study. 73 eyes of 65 patients treated with ≥2 IDI injections for RVO, UV or DME were included. IOP was assessed prior to and 1-2 weeks and 1 month after each IDI injection procedure. Differences in IOP changes, percentage of eyes with IOP change >10mmHg and percentage of eyes on hypotensive eyedrops with each injection were addresed. Subgroup analysis was performed for each treatment indication.
IOP spiked at month 1 in all timepoints and subgroups. Mean IOP increase at 1 month was 3.3±5.5 for the first, 2.1±4.4 for the second and 4.1±5.2 mmHg for the third IDI injection, without significant differences between injections (p=0.10, p=0.54). The percentage of eyes with IOP change ≥10mmHg at 1 month timepoint after the first injection was 13.2%, after the second injection was 8.6% and after the third injection was 10.7% respectively, without significant differences among groups (p=0.45). The percentage of eyes on hypotensive drops at baseline was 20% and 1 month after the first injection was 28.7% (p=0.30), after the second injection was 28,5% (p=0.52) and after the third injection was 36.6% (p=0.01). In the subgroup analysis by treatment indication, the percentage of eyes with IOP change ≥10mmHg was similar in eyes treated for RVO, UV or DME after the first (15%, 14.3% and 13.2%, p=0.91), second (13.3%, 4.5% and 9.5%, p=0.63), and third injection (20%, 0% and 11.1%, p=0.37).
Repeat IDI injections did not increase significantly IOP compared to the effect observed with the first injection. The IDI does not appear to have cumulative effect in IOP rise in our cohort of treated eyes, however, the percentage of eyes on hypotensive treatment was higher after 3 IDI injections than baseline. In our series, the effect on IOP was not significantly different in the subgroup analysis by treatment indication.
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