Intraocular Pressure after Intravitreal Injection of Dexamethasone Implant for Macular Edema Resulting from Retinal Vein Occlusion

Abstract

PURPOSE: A recognized side effect of corticosteroids intravitreal injections (IVT) is the onset of ocular hypertension. The aim of our study was to analyze changes in short-term intraocular pressure (IOP) after IVT of sustained-release dexamethasone implant in order to provide an appropriate monitoring scheme. METHODS: In this retrospective study, the charts of 44 eyes of 42 patients treated by IVT of dexamethasone implant for macular edema resulting from retinal vein occlusion were reviewed. The IOP measurements were performed at baseline and at 15 minutes, 7 days (D7), 1 month (M1), 2 months (M2), and 4 months (M4) after IVT. RESULTS: Mean IOP was 13.4 ± 2.5 mm Hg at baseline. Twelve eyes out of 44 (27.3%) were treated with antihypertensive eyedrops for a well-controlled glaucoma at baseline. Following IVT, mean IOP was 11.5 ± 3.6 mm Hg at 15 minutes, 14.7 ± 3.1 mm Hg at D7, 16.4 ± 7.0 mm Hg at M1, 19.3 ± 7.9 mm Hg at M2, and 13.5 ± 3.1 mm Hg at M4. An IOP ≥25 mm Hg or increased by 10 mm Hg or more was not observed in any eye at 15 minutes, D7, or M4 after IVT, but in 8.6% of cases at M1 and in 25% at M2. CONCLUSIONS: It seems reasonable to perform the first IOP monitoring 1 month after IVT of dexamethasone implant and at each efficacy assessment visit (M2, M4). Special attention should be given to patients at risk, such as glaucoma patients. An IOP measurement immediately after IVT and in the following days (1 week) does not seem to be appropriate on a routine basis.