The effects of temporary intraocular pressure spikes after intravitreal dexamethasone implantation on the retinal nerve fiber layer
Kendall W Wannamaker,1 Sarah Kenny,1 Rishi Das,1 Aaron Mendlovitz,2 Jordan M Comstock,1 Edward R Chu,1 Sepehr Bahadorani,1 Nathan J Gresores,2 Kinley D Beck,1 Chelsey J Krambeer,2 Daniel S Kermany,2 Roberto Diaz-Rohena,1 Daniel P Nolan,2 Jeong-Hyeon Sohn,1 Michael A Singer21Ophthalmology, University...
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Dove Medical Press
2019
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oai:doaj.org-article:ee8e2b202e804e32aa5160e0b31b1f5c2021-12-02T07:42:23ZThe effects of temporary intraocular pressure spikes after intravitreal dexamethasone implantation on the retinal nerve fiber layer1177-5483https://doaj.org/article/ee8e2b202e804e32aa5160e0b31b1f5c2019-06-01T00:00:00Zhttps://www.dovepress.com/the-effects-of-temporary-intraocular-pressure-spikes-after-intravitrea-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Kendall W Wannamaker,1 Sarah Kenny,1 Rishi Das,1 Aaron Mendlovitz,2 Jordan M Comstock,1 Edward R Chu,1 Sepehr Bahadorani,1 Nathan J Gresores,2 Kinley D Beck,1 Chelsey J Krambeer,2 Daniel S Kermany,2 Roberto Diaz-Rohena,1 Daniel P Nolan,2 Jeong-Hyeon Sohn,1 Michael A Singer21Ophthalmology, University of Texas Health Science Center San Antonio, San Antonio, TX, USA; 2Medical Center Ophthalmology Associates, San Antonio, TX, USABackground 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 ≥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 ≥3 months after IOP spike. Prospective inclusion criteria: OCT RNFL performed within 1 year prior to DEX implantation, IOP spike ≥22 mmHg up to 16 weeks after DEX implant, and OCT RNFL performed ≥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±15.5 μm and 82.6±15.8 μm, 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 ≥22 mmHg were similar (78.0±14.8 μm and 75.6±13.6 μm, 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®, dexamethasone, glaucoma, intraocular pressure, retinal nerve fiber layer, ocular hypertensionWannamaker KWKenny SDas RMendlovitz AComstock JMChu ERBahadorani SGresores NJBeck KDKrambeer CJKermany DSDiaz-Rohena RNolan DPSohn JHSinger MADove Medical PressarticleOzurdexdexamethasoneglaucomaintraocular pressureretinal nerve fiber layerocular hypertension.OphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 1079-1086 (2019) |
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Ozurdex dexamethasone glaucoma intraocular pressure retinal nerve fiber layer ocular hypertension. Ophthalmology RE1-994 |
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Ozurdex dexamethasone glaucoma intraocular pressure retinal nerve fiber layer ocular hypertension. Ophthalmology RE1-994 Wannamaker KW Kenny S Das R Mendlovitz A Comstock JM Chu ER Bahadorani S Gresores NJ Beck KD Krambeer CJ Kermany DS Diaz-Rohena R Nolan DP Sohn JH Singer MA The effects of temporary intraocular pressure spikes after intravitreal dexamethasone implantation on the retinal nerve fiber layer |
| description |
Kendall W Wannamaker,1 Sarah Kenny,1 Rishi Das,1 Aaron Mendlovitz,2 Jordan M Comstock,1 Edward R Chu,1 Sepehr Bahadorani,1 Nathan J Gresores,2 Kinley D Beck,1 Chelsey J Krambeer,2 Daniel S Kermany,2 Roberto Diaz-Rohena,1 Daniel P Nolan,2 Jeong-Hyeon Sohn,1 Michael A Singer21Ophthalmology, University of Texas Health Science Center San Antonio, San Antonio, TX, USA; 2Medical Center Ophthalmology Associates, San Antonio, TX, USABackground 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 ≥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 ≥3 months after IOP spike. Prospective inclusion criteria: OCT RNFL performed within 1 year prior to DEX implantation, IOP spike ≥22 mmHg up to 16 weeks after DEX implant, and OCT RNFL performed ≥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±15.5 μm and 82.6±15.8 μm, 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 ≥22 mmHg were similar (78.0±14.8 μm and 75.6±13.6 μm, 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®, dexamethasone, glaucoma, intraocular pressure, retinal nerve fiber layer, ocular hypertension |
| format |
article |
| author |
Wannamaker KW Kenny S Das R Mendlovitz A Comstock JM Chu ER Bahadorani S Gresores NJ Beck KD Krambeer CJ Kermany DS Diaz-Rohena R Nolan DP Sohn JH Singer MA |
| author_facet |
Wannamaker KW Kenny S Das R Mendlovitz A Comstock JM Chu ER Bahadorani S Gresores NJ Beck KD Krambeer CJ Kermany DS Diaz-Rohena R Nolan DP Sohn JH Singer MA |
| author_sort |
Wannamaker KW |
| title |
The effects of temporary intraocular pressure spikes after intravitreal dexamethasone implantation on the retinal nerve fiber layer |
| title_short |
The effects of temporary intraocular pressure spikes after intravitreal dexamethasone implantation on the retinal nerve fiber layer |
| title_full |
The effects of temporary intraocular pressure spikes after intravitreal dexamethasone implantation on the retinal nerve fiber layer |
| title_fullStr |
The effects of temporary intraocular pressure spikes after intravitreal dexamethasone implantation on the retinal nerve fiber layer |
| title_full_unstemmed |
The effects of temporary intraocular pressure spikes after intravitreal dexamethasone implantation on the retinal nerve fiber layer |
| title_sort |
effects of temporary intraocular pressure spikes after intravitreal dexamethasone implantation on the retinal nerve fiber layer |
| publisher |
Dove Medical Press |
| publishDate |
2019 |
| url |
https://doaj.org/article/ee8e2b202e804e32aa5160e0b31b1f5c |
| work_keys_str_mv |
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