Mansoori Tarannum, Shiva Swathi, Balakrishna Nagalla
Department of Glaucoma, Anand Eye Institute, Hyderabad, Telangana, India.
Department of Statistics, Apollo Institute of Medical Sciences, Hyderabad, Telangana, India.
Oman J Ophthalmol. 2022 Nov 2;15(3):299-303. doi: 10.4103/ojo.ojo_326_21. eCollection 2022 Sep-Dec.
To determine the incidence and risk factors for an increase in the intraocular pressure (IOP) after a single dexamethasone intravitreal implant (Ozurdex).
Medical records of 41 consecutive eyes who had received a single 0.7 mg Ozurdex implant for the various vitreoretinal pathology, between March 2015 and April 2016 were reviewed retrospectively. Ocular hypertension (OHT) was defined as IOP of >22 mmHg or an increase in the IOP of >6 mmHg from the baseline. Univariate regression analysis was used to measure the predictor of OHT after the implant.
Among the 41 eyes, who received a single Ozurdex intravitreal implant, 6/41 (14.6%) of the injected eyes had OHT, with the peak of IOP at 1 month after the injection when compared with the baseline IOP. Eight eyes (19.5%) had preexisting glaucoma or OHT, and 4/8 (50%) of them developed sustained elevation of IOP after the injection. Two eyes had transient OHT, a day after the implant, which did not require any treatment. All the eyes were managed with topical antiglaucoma medications and none required surgery to control the IOP. Preexisting OHT or glaucoma was found to be a significant risk factor for OHT after the Ozurdex injection ( < 0.0001).
Patients with preexisting OHT or glaucoma have an increased risk of OHT following the Ozurdex implant and hence needs to be informed of the possible risk. Follow-up at a regular interval is mandatory to monitor and recognize OHT early and treat it appropriately.
确定单次玻璃体内注射地塞米松植入剂(Ozurdex)后眼压升高的发生率及危险因素。
回顾性分析2015年3月至2016年4月期间连续41只因各种玻璃体视网膜病变接受单次0.7mg Ozurdex植入剂的患眼的病历。高眼压(OHT)定义为眼压>22mmHg或眼压较基线升高>6mmHg。采用单因素回归分析来测量植入后高眼压的预测因素。
在接受单次Ozurdex玻璃体内植入的41只眼中,6/41(14.6%)的注射眼发生了高眼压,与基线眼压相比,眼压峰值出现在注射后1个月。8只眼(19.5%)既往有青光眼或高眼压,其中4/8(50%)在注射后眼压持续升高。2只眼在植入后一天出现短暂性高眼压,无需任何治疗。所有患眼均使用局部抗青光眼药物治疗,无一例需要手术来控制眼压。发现既往有高眼压或青光眼是Ozurdex注射后发生高眼压的一个重要危险因素(<0.0001)。
既往有高眼压或青光眼的患者在Ozurdex植入后发生高眼压的风险增加,因此需要告知其可能的风险。必须定期随访,以早期监测和识别高眼压并进行适当治疗。