Intraocular pressure monitoring post intravitreal steroids: a systematic review.

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.

journal_name

Surv Ophthalmol

journal_title

Survey of ophthalmology

authors

Kiddee W,Trope GE,Sheng L,Beltran-Agullo L,Smith M,Strungaru MH,Baath J,Buys YM

doi

10.1016/j.survophthal.2012.08.003

subject

Has Abstract

pub_date

2013-07-01 00:00:00

pages

291-310

issue

4

eissn

0039-6257

issn

1879-3304

pii

S0039-6257(12)00183-X

journal_volume

58

pub_type

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