Abu Ishkheidem Imadeddin, Breimer Martin, Kamal Saba, Zetterberg Madeleine, Al-Hawasi Abbas, Grönlund Marita Andersson
Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Gothenburg University, Gothenburg, Sweden.
Department of Ophthalmology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
Acta Ophthalmol. 2025 Sep;103(6):699-706. doi: 10.1111/aos.17475. Epub 2025 Mar 5.
To evaluate the incidence and risk factors for secondary ocular hypertension (SOHT) following intravitreal dexamethasone implants (Ozurdex®) in patients with diabetic macular oedema (DME) and macular oedema secondary to retinal vein occlusion (RVO) in a Swedish cohort.
This retrospective study included 309 eyes from 249 patients treated with Ozurdex® at Sahlgrenska University Hospital, Mölndal, Sweden, from 1 January 2016 to 31 December 2023. Electronic medical records were reviewed for data including patient demographics, number of injections, incidence of and treatment modalities for SOHT and rate of Ozurdex® discontinuation.
Of the 309 eyes, 217 (70.2%) were in the DME group and 92 (29.8%) in the RVO group. Overall, 117 eyes (37.9%) developed SOHT (intraocular pressure (IOP) ≥25 mmHg or a rise of ≥10 mmHg from baseline); this included 77 of 217 DME eyes (35.5%) and 40 of 92 RVO eyes (43.5%). Men were more than twice as likely as women to develop SOHT (adjusted odds ratio [aOR]: 2.53, p < 0.001). Each unit increase in baseline IOP was associated with an 8% increase in the odds of SOHT (aOR: 1.08 p = 0.025). Of all eyes, 30.5% received IOP-lowering treatment, primarily prostaglandins. None required invasive surgery.
Our finding that 30.5% of eyes received IOP-lowering treatment confirms that SOHT is a prevalent complication following intravitreal dexamethasone implants. Male gender and higher baseline IOP were key indicators for developing SOHT after Ozurdex® treatment, emphasizing the need for vigilant monitoring. Most cases were managed with IOP-lowering eye drops, indicating that while common, SOHT is typically manageable without invasive interventions.
评估瑞典队列中糖尿病性黄斑水肿（DME）和视网膜静脉阻塞（RVO）继发黄斑水肿患者玻璃体内植入地塞米松（Ozurdex®）后继发性高眼压（SOHT）的发生率及危险因素。
这项回顾性研究纳入了2016年1月1日至2023年12月31日期间在瑞典默恩达尔萨尔格伦斯卡大学医院接受Ozurdex®治疗的249例患者的309只眼。查阅电子病历以获取数据，包括患者人口统计学信息、注射次数、SOHT的发生率及治疗方式以及Ozurdex®停药率。
309只眼中，217只（70.2%）在DME组，92只（29.8%）在RVO组。总体而言，117只眼（37.9%）发生了SOHT（眼压（IOP）≥25 mmHg或较基线升高≥10 mmHg）；其中217只DME眼中有77只（35.5%），92只RVO眼中有40只（43.5%）。男性发生SOHT的可能性是女性的两倍多（调整优势比[aOR]：2.53，p<0.001）。基线眼压每升高一个单位，发生SOHT的几率增加8%（aOR：1.08，p=0.025）。所有眼中，30.5%接受了降眼压治疗，主要是使用前列腺素。无人需要进行侵入性手术。
我们发现30.5%的眼睛接受了降眼压治疗，这证实了SOHT是玻璃体内植入地塞米松后的常见并发症。男性性别和较高的基线眼压是Ozurdex®治疗后发生SOHT的关键指标，强调了需要进行密切监测。大多数病例通过降眼压眼药水进行处理，这表明虽然SOHT常见，但通常无需侵入性干预即可控制。
