Intraocular pressure change after injection of intravitreal dexamethasone (Ozurdex) implant in Korean patients

Br J Ophthalmol. 2019 Oct;103(10):1380-1387. doi: 10.1136/bjophthalmol-2018-312958. Epub 2018 Dec 6.

Abstract

Background/aims: To analyse intraocular pressure (IOP) changes over a period of 1 year after intravitreal dexamethasone (DEX, Ozurdex) implant injection and to compare the results with those of previously published studies that involved non-Asian populations.

Methods: A retrospective observational study was conducted. A total of 540 eyes of 503 patients who received DEX implant injection and were diagnosed with macular oedema (ME) due to various retinal diseases were examined. IOP was measured prior to injection and at 1 week, 1 month, 2 months, 3 months, 6 months and 12 months after DEX implant injection. IOP elevation was divided into four categories: postinjection IOP of >35 mm Hg, >30 mm Hg and >25 mm Hg, and an IOP elevation of >10 mm Hg, relative to the baseline measurement.

Results: The mean baseline IOP was 13.45±2.95. The mean IOP gradually increased until 2 months postinjection (IOP=16.85±5.96 mm Hg, p<0.001) and then gradually decreased until 12 months postinjection (IOP=13.80±4.04mm Hg, p=0.16). IOP was >25 mm Hg in 57 eyes (10.6%), >30mm Hg in 29 eyes (5.4%) and >35mm Hg in 9 eyes (1.7%); IOP exhibited >10 mm Hg elevation from the baseline IOP in 61 eyes (11.3%). Overall, the incidence rate of IOP elevation after DEX treatment was 12.6% (68 eyes). Among the 68 eyes (12.6%) with elevated IOP, 60 (11.1%) required treatment: 59 (10.9%) required IOP-lowering medication and 1 (0.2%) ultimately required surgical interventions.

Conclusions: The incidence of adverse IOP elevation requiring the prolonged use of IOP-lowering medication and surgical intervention after DEX implantation was significantly lower than the incidence reported in previous Western population-based studies. Intravitreal DEX injection may therefore be an effective and relatively safe treatment modality for ME in Asian patients.

Keywords: dexamethasone implant; intraocular pressure; macular edema.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Dexamethasone / administration & dosage
  • Dexamethasone / adverse effects*
  • Drug Implants*
  • Female
  • Follow-Up Studies
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / adverse effects*
  • Humans
  • Incidence
  • Intraocular Pressure / drug effects*
  • Intraocular Pressure / physiology
  • Intravitreal Injections
  • Macular Edema / drug therapy*
  • Macular Edema / physiopathology
  • Male
  • Middle Aged
  • Ocular Hypertension / chemically induced*
  • Ocular Hypertension / physiopathology
  • Republic of Korea
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Tonometry, Ocular
  • Visual Acuity / physiology
  • Young Adult

Substances

  • Drug Implants
  • Glucocorticoids
  • Dexamethasone