Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2022 Sep;63(9):850-855. doi: 10.3349/ymj.2022.63.9.850.
In this study, we aimed to assess whether axial length (AXL) is a true risk factor for steroid-induced ocular hypertension (OHT). We hypothesized that the proportion of patients with steroid-induced OHT among individuals who have received intravitreal dexamethasone (DEX) injections would differ according to the AXL of their eyes.
A single-center, cross-sectional, case-control study was conducted on 467 eyes that underwent DEX implant injection owing to various retinal diseases. Intraocular pressure (IOP) was measured before the injection and 1 week and 1, 2, 3, 6, and 12 months after the injection. Enrolled patients were divided into OHT and normal IOP groups. Univariable logistic regression analysis was used to calculate odds ratios of steroid-induced OHT with significant variables being analyzed using a multivariable model.
A longer AXL was identified as a risk factor for steroid-induced OHT via both univariable and multivariable analyses, with an odds ratio of 1.216 [95% confidence interval (CI): 1.004-1.472, =0.0452]. The optimal cut-off value for AXL in terms of steroid-induced OHT was 23.585 mm, with an odds ratio of 2.355 (95% CI: 1.429-3.882, =0.0008).
Our findings indicate that a long AXL is a risk factor for steroid-induced OHT. Further, clinicians should be aware of steroid-induced OHT when treating patients with high myopia with steroids.
本研究旨在评估眼轴(AXL)是否为皮质类固醇激素诱导性高眼压(OHT)的真正危险因素。我们假设,接受玻璃体内注射地塞米松(DEX)的患者中,发生皮质类固醇激素诱导性 OHT 的患者比例会因眼轴长度不同而有所差异。
对因各种视网膜疾病而接受 DEX 植入物注射的 467 只眼进行了单中心、横断面、病例对照研究。在注射前及注射后 1 周和 1、2、3、6 和 12 个月测量眼内压(IOP)。将纳入的患者分为 OHT 和正常 IOP 组。使用单变量逻辑回归分析计算皮质类固醇激素诱导性 OHT 的优势比,对有显著意义的变量进行多变量模型分析。
单变量和多变量分析均表明,较长的 AXL 是皮质类固醇激素诱导性 OHT 的危险因素,其优势比为 1.216[95%置信区间(CI):1.004-1.472,=0.0452]。AXL 预测皮质类固醇激素诱导性 OHT 的最佳截断值为 23.585mm,优势比为 2.355(95%CI:1.429-3.882,=0.0008)。
我们的研究结果表明,长 AXL 是皮质类固醇激素诱导性 OHT 的危险因素。此外,当用皮质类固醇治疗高度近视患者时,临床医生应注意皮质类固醇激素诱导性 OHT。