Abstract
Purpose :
Intravitreal steroid use is often associated with an increase in the intraocular pressure (IOP) of the treated eye. This study sought to analyze the effects on IOP following intravitreal dexamethasone implant injections.
Methods :
In this retrospective cohort study, which was granted a waiver of authorization by the Institutional Review Board, IOP measurements were collected and analyzed using the Practice Management System at Retina Associates of Cleveland. The study focused on patients receiving a series of 2 or 3 intravitreal injections of a dexamethasone implant between 2017 and 2023. The mean IOP measurement for both treated and fellow eyes was collected at the baseline visit and compared to the mean IOP at the final visit. Likewise, the number of glaucoma medications for both treated and fellow eyes was measured at baseline and compared to the number at the final visit. The mean and median IOP and number of glaucoma medications at the baseline and final visit were calculated and compared using a t test.
Results :
A total of 154 patients receiving dexamethasone were identified with an average age of 72. Data collected showed the mean IOP at baseline was 14.8 mmHg (median 14 mmHg) for the treated eye and 14.7 mmHg (median 14 mmHg) for the fellow eye. At the final visit, the mean IOP was 19.4 mmHg (median 18 mmHg) for the treated eye and 18.7 mmHg (median 17 mmHg) for the fellow eye. This IOP change was found to be statistically significant (p = 0.0001) when compared with the IOP of the treated eye at the baseline visit. The mean number of glaucoma medications at baseline was 0.25 for the treated eye and 0.21 for the fellow eye which was not statistically significant (p = 0.49). At the final visit, the mean number of medications was 0.48 for the treated eye and 0.26 for the fellow eye (p=0.001).
Conclusions :
In this limited analysis, intravitreal dexamethasone implant appears to cause a statistically significant steroid related increase in IOP. Although there was a significant increase in IOP-lowering medications for treated eyes at the final visit, there is a persistent increase in IOP. Further studies with longer follow-up periods or additional injections could provide valuable insights.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.