Immediate Intraocular Pressure Changes Following Intravitreal Dexamethasone Implant

Area of Science:

• Ophthalmology
• Retinal Diseases
• Pharmacology

Background:

• Macular edema secondary to diabetic retinopathy and retinal vein occlusion are significant causes of vision impairment.
• Intravitreal corticosteroid implants, such as dexamethasone (Ozurdex), are utilized for managing these conditions.
• Understanding the immediate impact of the implantation procedure on intraocular pressure (IOP) is crucial for patient safety and management.

Purpose of the Study:

• To evaluate the immediate changes in intraocular pressure (IOP) following intravitreal dexamethasone implantation (Ozurdex).

Main Methods:

• A prospective study involving 34 eyes of 34 patients diagnosed with diabetic retinopathy or retinal vein occlusion.
• Intraocular pressure (IOP) was measured at baseline and at multiple time points (minute 1, minute 10, hour 1, day 1) post-implantation using a Tono-Pen XL.
• Eyes with visible reflux after implantation were analyzed as a separate subgroup.

Main Results:

• Overall, the only significant IOP change from baseline occurred immediately after implantation (minute 1), showing a decrease.
• In eyes with reflux (N=9), IOP was significantly lower at minute 1 and minute 10 post-implantation.
• In eyes without reflux (N=25), IOP remained stable, with no significant alterations at any measured time point. No wound leakage or choroidal detachment was observed.

Conclusions:

• The intravitreal dexamethasone implantation procedure itself does not generally affect IOP.
• Observable reflux during the implantation procedure can lead to a temporary decrease in IOP.
• These findings suggest the importance of monitoring IOP, particularly in cases with reflux, following Ozurdex implantation.