The pattern of intraocular pressure elevation in a specialized uveitis clinic

Shaaban, Ahmed Mohamed; Youssef, Mary; Eltanamly, Rasha M; Abdelaziz, Magda; Kotb, Mohamed

doi:10.4103/djo.djo_36_17

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“…Wherein, TA is administered as a suspension form [19], while Dex is administered as an implant. TA imparts an initial burst release of the drug, whereas Dex attains its peak therapeutic activity between 1 and 2 months [7,12,20]. The larger quantity and suspension form of TA could contribute to the early IOP rise by volume expansion or clogging trabecular meshwork.…”

Section: Discussionmentioning

confidence: 99%

Incidence, Risk Factors, Treatment, and Outcome of Ocular Hypertension following Intravitreal Steroid Injections: A Comparative Study

et al. 2022

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Purpose: To compare the incidence, risk factors, treatment, and outcomes associated with intravitreal triamcinolone-acetonide (TA) and dexamethasone-implant (Dex) induced ocular hypertension (OHT). Methods: This retrospective study reviewed 1549 TA and Dex administrations in 1075 eyes of 897 patients. Intraocular pressure (IOP) values were monitored for a period of 6-months following intravitreal injection(s) and patients were categorized as steroid-responders (SR): IOP ≥ 21mmHg, and non-responders (NR): IOP ≤ 20mmHg. Glaucoma patients, glaucoma suspects, uveitis, trauma, and less than one month IOP follow-up cases were excluded from the study. Incidence of IOP rise, time and magnitude of IOP rise, and its management procedures were studied. Ocular and systemic association with OHT incidence was investigated. Statistical analysis was performed using SPSS.23 and p < 0.05 was considered significant. Result: 28% of TA and 17% of Dex administered eyes developed OHT. Male subjects and elderly people (greater than 40 years) are at higher risk for OHT following steroid treatment. A high percentage of IOP rise was observed at day-1 (41%) for TA-SR, and after 1-month (50%) among Dex-SR. IOP rise was found to be more severe (>30mmHg) for TA-SR compared to Dex-SR (p=0.006). 6% TA-SR required trabeculectomy with medically uncontrollable IOP. Myopia is a risk factor for secondary OHT, whereas diabetes mellitus and hypercholesterolemia were protective of it. Conclusion: 28% of TA and 17% of Dex administrations developed OHT. Early and severe IOP rise was more common in TA than among Dex administrations. Myopia is a risk for Dex-OHT.

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Section: Discussionmentioning

confidence: 99%