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IOP monitoring following intravitreal steroid injection for retinal vein occlusion

Author: Maja Szymanska (United Kingdom)

Co-authors: Paolo Corazza, Ahmad Ali, Yasser Elazhary, Nancy Khairat, Saad Younis

Purpose

Ozurdex is a dexamethasone intravitreal implant used in the treatment of Diabetic macular oedema, macular oedema following branch or central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO) and noninfectious uveitis. Elevated intraocular pressure (IOP) is a major downside to dexamethasone implants. According to the GENEVA trial, peak intraocular pressure rise after Ozurdex injection occurs at 2 months. Therefore, the Royal College of Ophthalmologists recommends checking the IOP around 2 months post injection. The aim of this project was to investigate whether intraocular pressure is being checked at/around 2 months following treatment with Ozurdex as recommended by the royal college.

Setting/Venue

Western Eye Hospital, London, United Kingdom

Methods

Retrospective analysis of medical records of patients with CRVO and BRVO. Key outcomes included the IOP readings and time intervals of post-operative IOP measurement.

Results

The time to peak IOP was approximately 50 days after implantation, returning to baseline within 5 months. Amongst 85 patients with one or more Ozurdex injection (total 127 injections), majority of patients had their IOP measured between 10-30 days and 50 and 70 days postop (28% for each interval). The 2nd most common time interval was 30 to 50 days postop where 18.7% had their IOP measurement. 10.3% and 5.6% of the patients had their IOP measurement 70-90 and 90-110 days postop respectively which was late. Early measurement of IOP <10 days post op and too late after 110 days was found in 4.7% of the patients for each time interval. Regarding the change of intraocular pressure in cases with CRVO, there was statistically significant difference between baseline mean value and after 50 days (p value =0.003) respectively. Regarding the change of intraocular pressure in cases with BRVO, there was highly statistically significant change between baseline mean value and after 50 and 100 days (p value <0.001) respectively.

Conlusions

The peak IOP at the time interval of 50 to 70 days post injection, highlights the importance of checking the IOP during this interval. Clinicians should continue to follow the guidelines of the royal college and inform patients about the importance of checking IOP post Ozurdex at 2 months after the injection.

Financial Disclosure

none

Comments

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