Effects of Repeated Intravitreal Injections of Dexamethasone Implants on Intraocular Pressure: A 4-Year Study

Elena Pacella,1 Lorenzo Loffredo,2 Mariaelena Malvasi,1 Edoardo Trovato Battagliola,1 Daniela Messineo,3 Fernanda Pacella,1 Loredana Arrico1 1Department of Sense Organs, University of Rome La Sapienza, Rome, Italy; 2Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Science...

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Autores principales:	Pacella E, Loffredo L, Malvasi M, Trovato Battagliola E, Messineo D, Pacella F, Arrico L
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	intravitreal dexamethasone implant ozurdex injection hypertension side effect complications retinal vein occlusion; Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/85afce5dffbd4f45ab880cead056fba7
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spelling	oai:doaj.org-article:85afce5dffbd4f45ab880cead056fba72021-12-02T12:14:35ZEffects of Repeated Intravitreal Injections of Dexamethasone Implants on Intraocular Pressure: A 4-Year Study1177-5483https://doaj.org/article/85afce5dffbd4f45ab880cead056fba72020-10-01T00:00:00Zhttps://www.dovepress.com/effects-of-repeated-intravitreal-injections-of-dexamethasone-implants--peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Elena Pacella,1 Lorenzo Loffredo,2 Mariaelena Malvasi,1 Edoardo Trovato Battagliola,1 Daniela Messineo,3 Fernanda Pacella,1 Loredana Arrico1 1Department of Sense Organs, University of Rome La Sapienza, Rome, Italy; 2Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, University of Rome La Sapienza, Rome, Italy; 3Department of Radiological, Oncological and Pathological Anatomy Sciences, Sapienza University of Rome, Rome, ItalyCorrespondence: Fernanda PacellaDepartment of Sense Organs, University of Rome La Sapienza, Policlinico Umberto I, Viale del Policlinico 155 – 00161, Rome, ItalyTel +39 3333534396Email fernanda.pacella@gmail.comPurpose: Dexamethasone and other corticosteroids are administered intravitreally to treat a variety of retinal diseases. As a side effect, they can alter intraocular pressure (IOP). The purpose of this study is to describe the incidence, severity, and management of ocular hypertension following the administration of multiple intravitreal injections of dexamethasone implants.Materials and Methods: A total of 78 eyes of 78 subjects (males 62%; females 38%; mean age 67 ± 13 years SD) received a total of 152 intravitreal injections of 0.7 mg dexamethasone implants over 4 years. Indications included retinal vein occlusion (87%), diabetic macular edema (9%), wet-type age-related macular degeneration (4%). Ocular hypertension was defined as intraocular pressure above 23 mmHg or any pressure increase of 10 mmHg or more from baseline values. IOP was measured by applanation tonometry before the injection (T0), as well as one week (T1), one month (T2), and three months (T3) afterwards.Results: Five percent (4/78) of subjects developed ocular hypertension after the 1st injection. On the second and third rounds, additional 7.2% (3/42) and 4.2% (1/24) of subjects developed the same side effect. Among the 8 subjects who received a fourth injection, none was found with OHT. Pressure elevations were detected at T2 and T3. In all patients, topical medical therapy was sufficient to lower the IOP below threshold. Mean pressure variations following the first injection as compared to previous recorded values were +0.97 mmHg (T1), +0.92 mmHg (T2), and − 0.41 mmHg (T3) (p < 0.05). Mean pressure variations following the second injection were +0.54 mmHg (T1), +0.23 mmHg (T2) and − 0.66 mmHg (T3) (p < 0.05).Conclusion: Ocular hypertension is a recognized side effect of intravitreal dexamethasone. Some patients develop it right after the first injection, while others develop it subsequently, on the 2nd or 3rd round. This side effect becomes most apparent 30– 90 days following the implantation procedure and responds well to topical pressure-lowering medications.Keywords: intravitreal dexamethasone implant, Ozurdex injection, hypertension, side effect, complications, retinal vein occlusionPacella ELoffredo LMalvasi MTrovato Battagliola EMessineo DPacella FArrico LDove Medical Pressarticleintravitreal dexamethasone implantozurdex injectionhypertensionside effectcomplicationsretinal vein occlusion;OphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 3611-3617 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	intravitreal dexamethasone implant ozurdex injection hypertension side effect complications retinal vein occlusion; Ophthalmology RE1-994
spellingShingle	intravitreal dexamethasone implant ozurdex injection hypertension side effect complications retinal vein occlusion; Ophthalmology RE1-994 Pacella E Loffredo L Malvasi M Trovato Battagliola E Messineo D Pacella F Arrico L Effects of Repeated Intravitreal Injections of Dexamethasone Implants on Intraocular Pressure: A 4-Year Study
description	Elena Pacella,1 Lorenzo Loffredo,2 Mariaelena Malvasi,1 Edoardo Trovato Battagliola,1 Daniela Messineo,3 Fernanda Pacella,1 Loredana Arrico1 1Department of Sense Organs, University of Rome La Sapienza, Rome, Italy; 2Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, University of Rome La Sapienza, Rome, Italy; 3Department of Radiological, Oncological and Pathological Anatomy Sciences, Sapienza University of Rome, Rome, ItalyCorrespondence: Fernanda PacellaDepartment of Sense Organs, University of Rome La Sapienza, Policlinico Umberto I, Viale del Policlinico 155 – 00161, Rome, ItalyTel +39 3333534396Email fernanda.pacella@gmail.comPurpose: Dexamethasone and other corticosteroids are administered intravitreally to treat a variety of retinal diseases. As a side effect, they can alter intraocular pressure (IOP). The purpose of this study is to describe the incidence, severity, and management of ocular hypertension following the administration of multiple intravitreal injections of dexamethasone implants.Materials and Methods: A total of 78 eyes of 78 subjects (males 62%; females 38%; mean age 67 ± 13 years SD) received a total of 152 intravitreal injections of 0.7 mg dexamethasone implants over 4 years. Indications included retinal vein occlusion (87%), diabetic macular edema (9%), wet-type age-related macular degeneration (4%). Ocular hypertension was defined as intraocular pressure above 23 mmHg or any pressure increase of 10 mmHg or more from baseline values. IOP was measured by applanation tonometry before the injection (T0), as well as one week (T1), one month (T2), and three months (T3) afterwards.Results: Five percent (4/78) of subjects developed ocular hypertension after the 1st injection. On the second and third rounds, additional 7.2% (3/42) and 4.2% (1/24) of subjects developed the same side effect. Among the 8 subjects who received a fourth injection, none was found with OHT. Pressure elevations were detected at T2 and T3. In all patients, topical medical therapy was sufficient to lower the IOP below threshold. Mean pressure variations following the first injection as compared to previous recorded values were +0.97 mmHg (T1), +0.92 mmHg (T2), and − 0.41 mmHg (T3) (p < 0.05). Mean pressure variations following the second injection were +0.54 mmHg (T1), +0.23 mmHg (T2) and − 0.66 mmHg (T3) (p < 0.05).Conclusion: Ocular hypertension is a recognized side effect of intravitreal dexamethasone. Some patients develop it right after the first injection, while others develop it subsequently, on the 2nd or 3rd round. This side effect becomes most apparent 30– 90 days following the implantation procedure and responds well to topical pressure-lowering medications.Keywords: intravitreal dexamethasone implant, Ozurdex injection, hypertension, side effect, complications, retinal vein occlusion
format	article
author	Pacella E Loffredo L Malvasi M Trovato Battagliola E Messineo D Pacella F Arrico L
author_facet	Pacella E Loffredo L Malvasi M Trovato Battagliola E Messineo D Pacella F Arrico L
author_sort	Pacella E
title	Effects of Repeated Intravitreal Injections of Dexamethasone Implants on Intraocular Pressure: A 4-Year Study
title_short	Effects of Repeated Intravitreal Injections of Dexamethasone Implants on Intraocular Pressure: A 4-Year Study
title_full	Effects of Repeated Intravitreal Injections of Dexamethasone Implants on Intraocular Pressure: A 4-Year Study
title_fullStr	Effects of Repeated Intravitreal Injections of Dexamethasone Implants on Intraocular Pressure: A 4-Year Study
title_full_unstemmed	Effects of Repeated Intravitreal Injections of Dexamethasone Implants on Intraocular Pressure: A 4-Year Study
title_sort	effects of repeated intravitreal injections of dexamethasone implants on intraocular pressure: a 4-year study
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/85afce5dffbd4f45ab880cead056fba7
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Effects of Repeated Intravitreal Injections of Dexamethasone Implants on Intraocular Pressure: A 4-Year Study

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