September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Substained intraocular hypertension or steroids-induced Glaucoma after dexamethasone implant (DEX implant) intravitreal injection, myth or reality?
Author Affiliations & Notes
  • Amina Rezkallah
    Hôpital de la Croix Rousse, Lyon, France
  • Laurent Kodjikian
    Hôpital de la Croix Rousse, Lyon, France
  • Arianne Macles
    Hôpital d'instruction des armées Desgenettes, Lyon, France
  • Hussam El Chehab
    Hôpital d'instruction des armées Desgenettes, Lyon, France
  • Anne Laure Vie
    Hôpital de la Croix Rousse, Lyon, France
  • Emilie Agard
    Hôpital d'instruction des armées Desgenettes, Lyon, France
  • Anh Minh NGuyen
    Hôpital de la Croix Rousse, Lyon, France
  • Corinne Dot
    Hôpital d'instruction des armées Desgenettes, Lyon, France
  • Footnotes
    Commercial Relationships   Amina Rezkallah, None; Laurent Kodjikian, None; Arianne Macles, None; Hussam El Chehab, None; Anne Laure Vie, None; Emilie Agard, None; Anh Minh NGuyen, None; Corinne Dot, None
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 3286. doi:
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      Amina Rezkallah, Laurent Kodjikian, Arianne Macles, Hussam El Chehab, Anne Laure Vie, Emilie Agard, Anh Minh NGuyen, Corinne Dot; Substained intraocular hypertension or steroids-induced Glaucoma after dexamethasone implant (DEX implant) intravitreal injection, myth or reality?. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3286.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate the prevalence of substained intraocular hypertension (OHT) and steroids-induced glaucoma in patients who have presented an increased intraocular pressure (IOP), one or two months after DEX implant intravitreal injection (IVI).

Methods : A retrospective and bicentric study involving 32 patients without injection for more than 6 months, without history of OHT or glaucoma. All have presented an increased IOP consecutively to the DEX implant injection (≥ 25 mmHg or an increase ≥ 10mmHg).
The mean number of IVI was 2,13 +/- 1,33. The highest IOP was 27,57mmHg +/- 3,98 [25-37].
A complete bilateral exam has been performed at least 6 months after the last IVI. It has taken into account the measure of the IOP and the screening for glaucoma detection (C/D ratio, RNFL, Visual field, GCC measure). The major criteria was the presence of a substained corticosteroid-induced OHT and/or signs of corticosteroid-induced glaucoma.

Results : 32 eyes of 31 patients were included. The mean age of patients was 64,8 years +/- 10,6 years. The mean IOP during the control visit of the injected eye was 14 mmHg +/- 2,8 versus 15 mmHg +/- 4,2 for the non injected eye (p=0,39). The average pachymetry was 538mm +/- 30. The average cup/disk ratio of the injected eye was 0,26 versus 0,29 for non injected eye (p=0,4917). The mean RNFL of the injected eye was 97mm, versus 95mm (p=0,73). The measure of the thickness of the macular ganglion cell complex (GCC) was 66mm in the injected eye versus 71m (p=0,49).
No injected eye reported a substained OHT during the control visit (p=0,17). Three patients had bilateral chronic glaucoma initially undetected (3/31).

Conclusions : DEX implant is approved in the macular edema treatment secondary to diabetes, vein retinal occlusion and uveitis. OHT is reported to be transient and controlled with a topical treatment in most cases. Substained OHT induced by topical corticosteroids is known. That associated with DEX implants was still non estimated.
In this study we observed no cases of persistent corticosteroid-induced OHT or cortico-induced glaucoma.
The long-term IOP safety related to DEX implants IVI appears reassuring in this study. No substained OHT was reported after stopping injections

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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