Long-term outcomes after intravitreal dexamethasone treatment in steroid responders

Acta Diabetologica
Hasenin Al-KhersanDex Implant Study Group

Abstract

Intravitreal steroid implants have emerged as an adjunctive therapy in diabetic macular edema (DME) in patients refractory to anti-vascular endothelial growth factor agents. However, the use of these agents in patients with a prior history of steroid-induced ocular hypertension is limited. The present study aimed to analyze long-term intraocular pressure (IOP) response to the dexamethasone implant in patients with DME and a history of steroid-induced increase in IOP. In a multicenter retrospective review, 17 eyes with DME and a history of steroid-induced increase in IOP to > 21 mmHg were treated with the dexamethasone implant and followed for 18 months. Patients with a history of vitrectomy of vitreoretinal interface pathology were excluded. The primary outcomes were the change in IOP and use of IOP-lowering agents. Among the study population (17 eyes), there was no significant change in mean IOP from baseline through 18 months (15.9 ± 2.0-14.6 ± 2.8 mmHg; p = 0.18). The number of patients requiring IOP-lowering agents rose from 5 at baseline to 14 at 18 months (p = 0.0049). None of the study eyes required surgical treatment. Though dexamethasone does predictably lead to an increase in IOP, this adverse effect was effectively m...Continue Reading

References

Feb 15, 2012·Ophthalmology·Quan Dong NguyenUNKNOWN RISE and RIDE Research Group
Jul 26, 2013·Ophthalmic Surgery, Lasers & Imaging Retina·David TelanderSeenu M Hariprasad
Sep 16, 2016·Ophthalmic Surgery, Lasers & Imaging Retina·Michael E JansenMichael A Singer
Sep 24, 2016·Clinical Ophthalmology·Stephen G SchwartzHarry W Flynn
Oct 17, 2017·American Journal of Ophthalmology·Hasenin Al-KhersanUNKNOWN Dex Implant Study Group
Nov 3, 2017·Retina·Rekha SrinivasanUNKNOWN Sankara Nethralaya Vitreoretinal Study Group (SNVR Study Group)

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