Details

Autor(en) / Beteiligte

• Kiddee, Weerawat, MD
• Trope, Graham E., MB, PhD, FRCSC
• Sheng, Lisa, MD, MPH, PhD
• Beltran-Agullo, Laura, MD
• Smith, Michael, MBChB, FRCOphth
• Strungaru, M. Hermina, MD, PhD
• Baath, Jasrajbir, MD
• Buys, Yvonne M., MD, FRCSC

Titel

Intraocular Pressure Monitoring Post Intravitreal Steroids: A Systematic Review

Ist Teil von

• Survey of ophthalmology, 2013-07, Vol.58 (4), p.291-310

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2013

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract The use of intravitreal (IVT) corticosteroids for treatment of posterior segment diseases has increased significantly over the last decade. A commonly recognized complication of IVT steroids is secondary ocular hypertension (OHT) that can occur immediately secondary to direct intraocular volume increase or weeks to months later as a result of increased outflow resistance. We performed a meta-analysis and found 32% (95% confidence interval, 28.2–36.3) of individuals developed OHT following 4 mg IVT triamcinolone, 66% (50.2–78.8) and 79% (72.2–84.5) following 0.59 and 2.1 mg fluocinolone implant, respectively, and 11% (6.4–17.9) and 15% (9.2–24.3) following 0.35 and 0.7 mg dexamethasone implant, respectively. Risk factors included pre-existing glaucoma, higher baseline intraocular pressure (IOP), younger age, OHT following previous injection, uveitis, higher steroid dosage, and fluocinolone implant. Most cases of OHT can be controlled medically; up to 45% following fluocinolone implant require surgery, however. We suggest a protocol to monitor IOP after IVT steroid injection/implantation that includes checking IOP within 30 minutes after injection, followed by 1 week after IVT triamcinolone and 2 weeks after implant insertion, then every 2 weeks for the first month and monthly for up to 6 months after IVT triamcinolone and dexamethasone implantation and 9 months after fluocinolone implantation.