Abstract
Purpose :
To evaluate the relationship between the optic nerve’s cup-to-disc ratio (CDR) and the risk for steroid response after intravitreal injection (IVI) of corticosteroids
Methods :
Retrospective chart review of eyes that underwent treatment with intravitreal corticosteroid injections for various indications. The study eyes were followed for 1 year prior to and 1 year after the first IVI treatment with either triamcinolone acetonide (4mg) or dexamethasone (0.7 mg). The collected data included baseline CDR on fundus exam, indication for treatment, baseline IOP before IVI and IOP at all follow-up visits for up to 1 year. History of glaucoma, glaucoma suspect, family history of glaucoma, and use of pressure-lowering drops were also recorded. A steroid responder was defined as having an IOP of at least 25mmHg or an increase of 10mmHg from baseline during the first year following the injection. CDR between steroid responder eyes and non-responder eyeswere then compared and analyzed.
Results :
Among 145 eyes that met the inclusion criteria, steroid response (SR) was found in 20% (29/145) of injected eyes over a mean follow-up period of 12 months. IOP-lowering medication was deemed appropriate for 20.7% (6/29) of these eyes. Mean time to IOP spike was 106.2 days, with a median of 84 days. SR was found in 28.2% (11/39) of patients with CDR ≥ 0.5 and in 16.9% (18/106) of patients with CDR < 0.5. Having a CDR ≥0.5 at baseline was associated with 1.92 times increased odds of developing a steroid response (95% CI 0.81-4.54). Rates of steroid response in eyes receiving triamcinolone acetonide and dexamethasone were found to be similar at 19.4% (21/108) and 21.0% (8/38) respectively.
Conclusions :
Eyes with CDR ≥0.5 at baseline might be at higher risk for steroid responseand for that reason they should be carefully followed after IVI.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.