University of Health Sciences Turkey, Fatih Sultan Mehmet Training and Research Hospital, Clinic of Ophthalmology, İstanbul, Turkey.
Pendik Public Hospital, Clinic of Ophthalmology, İstanbul, Turkey.
Turk J Ophthalmol. 2021 Dec 28;51(6):365-372. doi: 10.4274/tjo.galenos.2021.77864.
This study aimed to retrospectively evaluate the intraocular pressure (IOP) change in vitrectomized and non-vitrectomized patients receiving 0.7 mg intravitreal dexamethasone implant to treat macular edema due to different indications.
The patients' diagnoses, IOP values before receiving the intravitreal dexamethasone implant and in follow-up examinations at 1-3 days, 1 month, 2 months, 3 months, 6 months, 9 months, and 12 months after implantation, pachymetry values, medications used, and history of vitrectomy surgery were recorded.
A total of 134 eyes of 112 patients between 46 and 85 years of age who received intravitreal dexamethasone implants were evaluated. Seventeen eyes (12.7%) were vitrectomized and 117 (87.3%) were not vitrectomized. In non-vitrectomized eyes, the mean IOP was 14.01±2.36 mmHg before and 14.8±2.96 at 1-3 days, 16.71±3.97 at 1 month, 17.88±5.27 at 2 months, 15.54±3.35 at 3 months, 15.1±3.24 at 6 months, and 14.61±3.71 mmHg at 12 months after receiving the first dose. In this group, the increases in mean IOP at 1-3 days, 1 month, 2 months, and 3 months were significant compared to the mean IOP before the first dose (p<0.05). In vitrectomized eyes, only the increase in mean IOP at 6 months was significant compared to the mean IOP before the first dose (p<0.05). Twenty-three of the 134 eyes (17.2%) were prescribed 1-3 medications due to IOP elevation (one drug for 73.9%, two drugs for 17.4%, and three drugs for 8.7% of these eyes).
The IOP increase that occurs as a side effect of intravitreal dexamethasone administration is generally mild and temporary in both vitrectomized and non-vitrectomized eyes, regardless of indication. There was no cumulative effect in patients who received two or three doses.
本研究旨在回顾性评估因不同适应证接受 0.7mg 玻璃体内注射地塞米松植入物治疗黄斑水肿的玻璃体切割术和非玻璃体切割术患者的眼压（IOP）变化。
记录患者的诊断、接受玻璃体内注射地塞米松植入物前的 IOP 值以及植入后 1-3 天、1 个月、2 个月、3 个月、6 个月、9 个月和 12 个月的随访检查时的 IOP 值、眼内压计值、所用药物以及玻璃体切割手术史。
共评估了 112 例年龄在 46-85 岁之间的 134 只眼，这些患者均接受了玻璃体内注射地塞米松植入物治疗。17 只眼（12.7%）接受了玻璃体切割术，117 只眼（87.3%）未接受玻璃体切割术。在非玻璃体切割眼中，接受首次剂量前的平均 IOP 为 14.01±2.36mmHg，接受首次剂量后 1-3 天为 14.8±2.96mmHg，1 个月时为 16.71±3.97mmHg，2 个月时为 17.88±5.27mmHg，3 个月时为 15.54±3.35mmHg，6 个月时为 15.1±3.24mmHg，12 个月时为 14.61±3.71mmHg。在该组中，与首次剂量前的平均 IOP 相比，1-3 天、1 个月、2 个月和 3 个月时的平均 IOP 升高均具有统计学意义（p<0.05）。在玻璃体切割眼中，只有在 6 个月时的平均 IOP 升高与首次剂量前的平均 IOP 相比具有统计学意义（p<0.05）。在 134 只眼中，有 23 只（17.2%）由于眼压升高而开了 1-3 种药物（73.9%的患者使用一种药物，17.4%的患者使用两种药物，8.7%的患者使用三种药物）。
无论适应证如何，玻璃体内注射地塞米松引起的眼压升高在玻璃体切割眼和非玻璃体切割眼中均为轻度且暂时的，接受两剂或三剂药物治疗的患者没有累积效应。
