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David G. Dodwell, Darrel A. Krimmel; IOP in Patients after Multiple Ozurdex Implants for Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2012;53(14):928.
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© ARVO (1962-2015); The Authors (2016-present)
Evaluate the intraocular pressure (IOP) in patients receiving serial intravitreal Ozurdex (IVO) therapy for macular edema (ME) secondary to branch-(BRVO) or central retinal vein occlusion (CRVO)
Single center, retrospective, consecutive case study of all patients receiving 2 or more IVO implants for ME secondary RVO, with at least 3 months(mo) follow-up(f/u) after last IVO. Patients were monitored every 3-6 weeks(wk) after IVO with Cirrus HD-OCT(Zeiss). IVO was given in a treat and extend method with retreatment (re-Rx) after recurrent ME was observed on OCT. VA, IOP (Tonopen/pneumotonometry) and OCT data were acquired at all visits.
37 eyes of 37 patients with ME secondary to RVO (8 CRVO, 29 BRVO) received a total of 165 IVO, mean: 4.5 IVO/patient (2-10) during a mean f/u after first IVO of 71 wk(26-103). IVO consistently decreased ME on OCT. IVO re-Rx occurred at a mean of 17.4 wk(9-61) after prior IVO. At first IVO, mean IOP was 14.8 mmHg(9-22) and 10 eyes were on topical glaucoma therapy (27%). Of these, 2 eyes had open angle glaucoma and 8 had triamcinolone (TA)-induced glaucoma from prior therapy. During f/u of all 37 eyes, the mean highest IOP change from baseline was +7.46 mmHg (-3-+20). Post-IVO IOP increased ≥10 mmHg in 10 eyes (27%). The mean highest IOP change from baseline in these 10 eyes was +15.5 mmHg (+11-+20). Of the ten eyes with ≥10 mmHg elevation in IOP, 4 eyes increased after 1st IVO and 3, 1, and 2 eyes increased ≥10 mmHg after the 2nd, 3rd, and 4th IVO, respectively. 2 of 10 eyes(20%) on topical glaucoma therapy prior to 1st IVO and 8 of 27(30%) eyes not on glaucoma therapy prior to 1st IVO had an IOP increase of >10 mm Hg. Topical glaucoma therapy at 1st IVO was not a risk factor for subsequent IOP elevation post-IVO(t=0.586; p=0.562). 3 eyes had glaucoma valves implanted: 1 had no history of glaucoma or prior steroid therapy and 2 had been on 3-4 glaucoma drops for TA-induced glaucoma before IVO therapy. No patient developed rubeosis iridis.
Topical glaucoma therapy prior to IVO treatment was not a risk factor for IOP elevation and did not prevent successful serial IVO. Multiple IVO for ME secondary to RVO, given an average of every 4 months, was safe and effective. Any Increase in IOP was well controlled and did not prevent continued IVO. Further study regarding the frequency of IVO for ME secondary to RVO may be of benefit.
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