학술논문
The effects of temporary intraocular pressure spikes after intravitreal dexamethasone implantation on the retinal nerve fiber layer
ORIGINAL RESEARCH
ORIGINAL RESEARCH
Document Type
Academic Journal
Author
Source
Clinical Ophthalmology. July 2019, p1079, 7 p.
Subject
Language
English
ISSN
1177-5483
Abstract
Background and objective Intravitreal steroid injections have been shown to be an effective means by which to treat macular edema secondary to a wide array of etiologies including diabetes, retinal [...]
Background and objective: The dexamethasone (DEX) implant is known to cause temporary intraocular pressure (IOP) spikes after implantation. The purpose of this study is to determine if IOP spikes after DEX implant cause significant thinning in the retinal nerve fiber layer (RNFL). Study design, patients, and methods: A total of 306 charts were reviewed with 48 and 21 patients meeting inclusion criteria for the cross-sectional and prospective groups, respectively. Cross-sectional inclusion criteria: IOP spike [greater than or equal to]22 mmHg up to 16 weeks after DEX implant, DEX implant in only 1 eye per patient, and spectral-domain optical coherence tomography (OCT) RNFL imaging of both eyes [greater than or equal to]3 months after IOP spike. Prospective inclusion criteria: OCT RNFL performed within 1 year prior to DEX implantation, IOP spike [greater than or equal to]22 mmHg up to 16 weeks after DEX implant, and OCT RNFL performed [greater than or equal to]3 months after IOP spike. The average RNFL thickness in the contralateral eye was used as the control in the cross-sectional group. Institutional review board approval was obtained. Results: In the cross-sectional group, there was no statistically significant difference in the mean RNFL thicknesses in the treated vs untreated eyes (80.4[+ or -]15.5 [micro]m and 82.6[+ or -]15.8 [micro]m, respectively; P=0.33) regardless of treatment diagnosis, magnitude of IOP spike, or history of glaucoma. In the prospective group, mean RNFL thicknesses before and after IOP spikes [greater than or equal to]22 mmHg were similar (78.0[+ or -]14.8 [micro]m and 75.6[+ or -]13.6 [micro]m, respectively; P=0.13). Conclusion and relevance: Temporary elevation of IOP after DEX implantation when treated with topical IOP lowering drops does not appear to lead to a meaningful change in RNFL thickness. Keywords: Ozurdex[R], dexamethasone, glaucoma, intraocular pressure, retinal nerve fiber layer, ocular hypertension
Background and objective: The dexamethasone (DEX) implant is known to cause temporary intraocular pressure (IOP) spikes after implantation. The purpose of this study is to determine if IOP spikes after DEX implant cause significant thinning in the retinal nerve fiber layer (RNFL). Study design, patients, and methods: A total of 306 charts were reviewed with 48 and 21 patients meeting inclusion criteria for the cross-sectional and prospective groups, respectively. Cross-sectional inclusion criteria: IOP spike [greater than or equal to]22 mmHg up to 16 weeks after DEX implant, DEX implant in only 1 eye per patient, and spectral-domain optical coherence tomography (OCT) RNFL imaging of both eyes [greater than or equal to]3 months after IOP spike. Prospective inclusion criteria: OCT RNFL performed within 1 year prior to DEX implantation, IOP spike [greater than or equal to]22 mmHg up to 16 weeks after DEX implant, and OCT RNFL performed [greater than or equal to]3 months after IOP spike. The average RNFL thickness in the contralateral eye was used as the control in the cross-sectional group. Institutional review board approval was obtained. Results: In the cross-sectional group, there was no statistically significant difference in the mean RNFL thicknesses in the treated vs untreated eyes (80.4[+ or -]15.5 [micro]m and 82.6[+ or -]15.8 [micro]m, respectively; P=0.33) regardless of treatment diagnosis, magnitude of IOP spike, or history of glaucoma. In the prospective group, mean RNFL thicknesses before and after IOP spikes [greater than or equal to]22 mmHg were similar (78.0[+ or -]14.8 [micro]m and 75.6[+ or -]13.6 [micro]m, respectively; P=0.13). Conclusion and relevance: Temporary elevation of IOP after DEX implantation when treated with topical IOP lowering drops does not appear to lead to a meaningful change in RNFL thickness. Keywords: Ozurdex[R], dexamethasone, glaucoma, intraocular pressure, retinal nerve fiber layer, ocular hypertension