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Javier Zarranz-Ventura, Anna Sala-Puigdollers, Daniel Velazquez Villoria, Marc Figueras-Roca, Sergio Copete, Laura Natalia Distefano, Anna Boixadera Espax, Jose Garcia-Arumi, Alfredo Adan Civera; Dexamethasone implant (Ozurdex©) intraocular pressure outcomes in the real-world. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4153.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the real-world intraocular pressure (IOP) outcomes in a large cohort of eyes treated with the intravitreal dexamethasone implant (Ozurdex©).
Retrospective, two center, consecutive case series. 705 Ozurdex implants were injected in 438 eyes (403 patients) in two tertiary referral public centers (Hospital Clinic and Hospital Vall de Hebron, Barcelona, Spain). Clinical data collected included: Indication, injection dates, number of injections, previous treatments, and IOP prior to injection, 1-2 weeks and 6-8 weeks post-each injection. Proportion of glaucoma, ocular hypertension and eyes on hypotensive treatment at baseline, IOP change with repeat injections, cumulative incidence of IOP-lowering treatment need and proportion of eyes requiring glaucoma surgery were determined.
Indications were diabetic macular edema in 47.3%, retinal vein occlusion in 28.6%, uveitis in 13% and others in 10.9%. At baseline, 8.8% of study eyes had glaucoma, 6.7% ocular hypertension and 16.9% were already on hypotensive topical treatment. IOP change at 6-8 weeks after first injection was +2.27±5.8, after second injection was +2.99±5.2 (p<0.001), after third injection was +3.39±5.8 (p<0.001) and after fourth injection was +4.55±5.3 (p<0.001). Once eyes on topical IOP-lowering treatment at baseline were excluded, the cumulative probability of starting topical treatment was 10.8% at 1 month, 18.5% at 2 months, 21.0% at 4 months, 23.7% at 6 months, 30.4% at 12 months, and 53.1% at 24 months. Glaucoma surgery was required in 0.91% of study eyes (4/438).
Repeated Ozurdex injections associate IOP changes of significantly higher magnitude, however the difference does not appear to be of clinical significance. The probability of starting IOP-lowering treatment increases with repeated injections. The percentage of treated eyes which require glaucoma surgery is very low (<1%) and consistent with the literature.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
Box and whisker plot representing intraocular pressure change from baseline with each injection (6-8 weeks post-treatment). Significant differences were observed between each injection (p<0.001), although the range of variation appears clinically non-significant (range +2.27 to +4.55).
Kaplan Meier plot representing cumulative probability of IOP lowering treatment initiation after first injection, including only IOP lowering treatment-free eyes at baseline (83.1% of the study sample).
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