Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
Br J Ophthalmol. 2019 Oct;103(10):1380-1387. doi: 10.1136/bjophthalmol-2018-312958. Epub 2018 Dec 6.
BACKGROUND/AIMS: To analyse intraocular pressure (IOP) changes over a period of 1 year after intravitreal dexamethasone (DEX, Ozurdex) implant injection and to compare the results with those of previously published studies that involved non-Asian populations.
A retrospective observational study was conducted. A total of 540 eyes of 503 patients who received DEX implant injection and were diagnosed with macular oedema (ME) due to various retinal diseases were examined. IOP was measured prior to injection and at 1 week, 1 month, 2 months, 3 months, 6 months and 12 months after DEX implant injection. IOP elevation was divided into four categories: postinjection IOP of >35 mm Hg, >30 mm Hg and >25 mm Hg, and an IOP elevation of >10 mm Hg, relative to the baseline measurement.
The mean baseline IOP was 13.45±2.95. The mean IOP gradually increased until 2 months postinjection (IOP=16.85±5.96 mm Hg, p<0.001) and then gradually decreased until 12 months postinjection (IOP=13.80±4.04mm Hg, p=0.16). IOP was >25 mm Hg in 57 eyes (10.6%), >30mm Hg in 29 eyes (5.4%) and >35mm Hg in 9 eyes (1.7%); IOP exhibited >10 mm Hg elevation from the baseline IOP in 61 eyes (11.3%). Overall, the incidence rate of IOP elevation after DEX treatment was 12.6% (68 eyes). Among the 68 eyes (12.6%) with elevated IOP, 60 (11.1%) required treatment: 59 (10.9%) required IOP-lowering medication and 1 (0.2%) ultimately required surgical interventions.
The incidence of adverse IOP elevation requiring the prolonged use of IOP-lowering medication and surgical intervention after DEX implantation was significantly lower than the incidence reported in previous Western population-based studies. Intravitreal DEX injection may therefore be an effective and relatively safe treatment modality for ME in Asian patients.
背景/目的:分析玻璃体内注射地塞米松(DEX,Ozurdex)植入物后 1 年内的眼压(IOP)变化,并与涉及非亚洲人群的先前发表的研究结果进行比较。
进行了一项回顾性观察性研究。共检查了 503 例 540 只眼,这些患者因各种视网膜疾病而接受 DEX 植入物注射并被诊断为黄斑水肿(ME)。在注射前和注射后 1 周、1 个月、2 个月、3 个月、6 个月和 12 个月测量 IOP。将眼压升高分为 4 类:注射后眼压>35mmHg、>30mmHg 和>25mmHg,以及眼压升高>10mmHg,与基线测量值相比。
平均基线 IOP 为 13.45±2.95mmHg。平均眼压逐渐升高,直到注射后 2 个月(IOP=16.85±5.96mmHg,p<0.001),然后逐渐下降,直到注射后 12 个月(IOP=13.80±4.04mmHg,p=0.16)。57 只眼(10.6%)的 IOP>25mmHg,29 只眼(5.4%)的 IOP>30mmHg,9 只眼(1.7%)的 IOP>35mmHg;61 只眼(11.3%)的眼压比基线眼压升高>10mmHg。总体而言,DEX 治疗后眼压升高的发生率为 12.6%(68 只眼)。在 68 只眼压升高的眼(12.6%)中,60 只(11.1%)需要治疗:59 只(10.9%)需要降眼压药物治疗,1 只(0.2%)最终需要手术干预。
DEX 植入后需要长期使用降眼压药物和手术干预的不良反应性眼压升高的发生率明显低于以前基于西方人群的研究报告的发生率。因此,玻璃体内注射 DEX 可能是亚洲患者 ME 的一种有效且相对安全的治疗方式。