Association between Early Anatomic Response and Intraocular Pressure Change after Intravitreal Dexamethasone Implant: An Optical Coherence Tomography Study
Abstract
:1. Introduction
2. Methods
2.1. Inclusion and Exclusion Criteria
2.2. Intravitreal DEX Implantation
2.3. Outcome Measurements
2.4. Association between IOP Change and CST Change after DEX Implantation
2.5. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Degree of CST Reduction According to IOP Change
3.3. Degree of IOP Elevation According to CST Change
3.4. Correlation between IOP Change and CST Reduction
4. Discussion
Author Contributions
Funding
Conflicts of Interest
References
- Haller, J.A.; Bandello, F.; Belfort, R., Jr.; Blumenkranz, M.S.; Gillies, M.; Heier, J.; Loewenstein, A.; Yoon, Y.H.; Jacques, M.L.; Jiao, J.; et al. Randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with macular edema due to retinal vein occlusion. Ophthalmology 2010, 117, 1134–1146.e1133. [Google Scholar] [CrossRef] [PubMed]
- Boyer, D.S.; Faber, D.; Gupta, S.; Patel, S.S.; Tabandeh, H.; Li, X.Y.; Liu, C.C.; Lou, J.; Whitcup, S.M. Dexamethasone intravitreal implant for treatment of diabetic macular edema in vitrectomized patients. Retina 2011, 31, 915–923. [Google Scholar] [CrossRef] [PubMed]
- Haller, J.A.; Bandello, F.; Belfort, R., Jr.; Blumenkranz, M.S.; Gillies, M.; Heier, J.; Loewenstein, A.; Yoon, Y.H.; Jiao, J.; Li, X.Y.; et al. Dexamethasone intravitreal implant in patients with macular edema related to branch or central retinal vein occlusion twelve-month study results. Ophthalmology 2011, 118, 2453–2460. [Google Scholar] [CrossRef] [PubMed]
- Lowder, C.; Belfort, R., Jr.; Lightman, S.; Foster, C.S.; Robinson, M.R.; Schiffman, R.M.; Li, X.Y.; Cui, H.; Whitcup, S.M. Dexamethasone intravitreal implant for noninfectious intermediate or posterior uveitis. Arch. Ophthalmol. 2011, 129, 545–553. [Google Scholar] [CrossRef] [PubMed]
- Robinson, M.R.; Whitcup, S.M. Pharmacologic and clinical profile of dexamethasone intravitreal implant. Expert Rev. Clin. Pharmacol. 2012, 5, 629–647. [Google Scholar] [CrossRef]
- Boyer, D.S.; Yoon, Y.H.; Belfort, R., Jr.; Bandello, F.; Maturi, R.K.; Augustin, A.J.; Li, X.Y.; Cui, H.; Hashad, Y.; Whitcup, S.M. Three-year, randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with diabetic macular edema. Ophthalmology 2014, 121, 1904–1914. [Google Scholar] [CrossRef]
- Capone, A., Jr.; Singer, M.A.; Dodwell, D.G.; Dreyer, R.F.; Oh, K.T.; Roth, D.B.; Walt, J.G.; Scott, L.C.; Hollander, D.A. Efficacy and safety of two or more dexamethasone intravitreal implant injections for treatment of macular edema related to retinal vein occlusion (Shasta study). Retina 2014, 34, 342–351. [Google Scholar] [CrossRef]
- Maturi, R.K.; Pollack, A.; Uy, H.S.; Varano, M.; Gomes, A.M.; Li, X.Y.; Cui, H.; Lou, J.; Hashad, Y.; Whitcup, S.M. Intraocular pressure in patients with diabetic macular edema treated with dexamethasone intravitreal implant in the 3-year mead study. Retina 2016, 36, 1143–1152. [Google Scholar] [CrossRef]
- Thakur, A.; Kadam, R.; Kompella, U.B. Trabecular meshwork and lens partitioning of corticosteroids: Implications for elevated intraocular pressure and cataracts. Arch. Ophthalmol. 2011, 129, 914–920. [Google Scholar] [CrossRef] [Green Version]
- Chae, J.B.; Joe, S.G.; Yang, S.J.; Lee, J.Y.; Kim, J.G.; Yoon, Y.H. An increase in intraocular pressure after intravitreal steroid injection facilitates reduction of macular edema. Eye 2012, 26, 479–480. [Google Scholar] [CrossRef] [Green Version]
- Kim, K.T.; Lee, H.; Kim, J.Y.; Lee, S.; Chae, J.B.; Kim, D.Y. Long-Term Visual/Anatomic Outcome in Patients with Fovea-Involving Fibrovascular Pigment Epithelium Detachment Presenting Choroidal Neovascularization on Optical Coherence Tomography Angiography. J. Clin. Med. 2020, 9, 1863. [Google Scholar] [CrossRef] [PubMed]
- Rhee, D.J.; Peck, R.E.; Belmont, J.; Martidis, A.; Liu, M.; Chang, J.; Fontanarosa, J.; Moster, M.R. Intraocular pressure alterations following intravitreal triamcinolone acetonide. Br. J. Ophthalmol. 2006, 90, 999–1003. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Shah, A.R.; Yonekawa, Y.; Todorich, B.; Van Laere, L.; Hussain, R.; Woodward, M.A.; Abbey, A.M.; Wolfe, J.D. Prediction of Anti-VEGF Response in Diabetic Macular Edema After 1 Injection. J. Vitreoretinal Dis. 2017, 1, 169–174. [Google Scholar] [CrossRef] [PubMed]
- Jones, R., 3rd; Rhee, D.J. Corticosteroid-induced ocular hypertension and glaucoma: A brief review and update of the literature. Curr. Opin. Ophthalmol. 2006, 17, 163–167. [Google Scholar] [CrossRef] [PubMed]
- Clark, A.F.; Wilson, K.; McCartney, M.D.; Miggans, S.T.; Kunkle, M.; Howe, W. Glucocorticoid-induced formation of cross-linked actin networks in cultured human trabecular meshwork cells. Investig. Ophthalmol. Vis. Sci. 1994, 35, 281–294. [Google Scholar]
- Wilson, K.; McCartney, M.D.; Miggans, S.T.; Clark, A.F. Dexamethasone induced ultrastructural changes in cultured human trabecular meshwork cells. Curr. Eye Res. 1993, 12, 783–793. [Google Scholar] [CrossRef]
- Weinreb, R.N.; Mitchell, M.D.; Polansky, J.R. Prostaglandin production by human trabecular cells: In vitro inhibition by dexamethasone. Investig. Ophthalmol. Vis. Sci. 1983, 24, 1541–1545. [Google Scholar]
- Wordinger, R.J.; Clark, A.F. Effects of glucocorticoids on the trabecular meshwork: Towards a better understanding of glaucoma. Prog. Retin. Eye Res. 1999, 18, 629–667. [Google Scholar] [CrossRef]
- Van der Valk, R.; Schouten, J.S.; Webers, C.A.; Beckers, H.J.; van Amelsvoort, L.G.; Schouten, H.J.; Hendrikse, F.; Prins, M.H. The impact of a nationwide introduction of new drugs and a treatment protocol for glaucoma on the number of glaucoma surgeries. J. Glaucoma 2005, 14, 239–242. [Google Scholar] [CrossRef]
- Neufeld, A.H.; Dueker, D.K.; Vegge, T.; Sears, M.L. Adenosine 3′,5′-monophosphate increases the outflow of aqueous humor from the rabbit eye. Investig. Ophthalmol. 1975, 14, 40–42. [Google Scholar]
- Dinarello, C.A. Interleukin-1 and interleukin-1 antagonism. Blood 1991, 77, 1627–1652. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Alvarado, J.A.; Alvarado, R.G.; Yeh, R.F.; Franse-Carman, L.; Marcellino, G.R.; Brownstein, M.J. A new insight into the cellular regulation of aqueous outflow: How trabecular meshwork endothelial cells drive a mechanism that regulates the permeability of Schlemm’s canal endothelial cells. Br. J. Ophthalmol. 2005, 89, 1500–1505. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Fini, M.E.; Schwartz, S.G.; Gao, X.; Jeong, S.; Patel, N.; Itakura, T.; Price, M.O.; Price, F.W., Jr.; Varma, R.; Stamer, W.D. Steroid-induced ocular hypertension/glaucoma: Focus on pharmacogenomics and implications for precision medicine. Prog. Retin. Eye Res. 2017, 56, 58–83. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Mastropasqua, R.; D’Aloisio, R.; Di Nicola, M.; Di Martino, G.; Lamolinara, A.; Di Antonio, L.; Tognetto, D.; Toto, L. Relationship between aqueous humor cytokine level changes and retinal vascular changes after intravitreal aflibercept for diabetic macular edema. Sci. Rep. 2018, 8, 16548. [Google Scholar] [CrossRef] [PubMed]
- Oakley, R.H.; Cidlowski, J.A. Cellular processing of the glucocorticoid receptor gene and protein: New mechanisms for generating tissue-specific actions of glucocorticoids. J. Biol. Chem. 2011, 286, 3177–3184. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Chin, E.K.; Almeida, D.R.P.; Velez, G.; Xu, K.; Peraire, M.; Corbella, M.; Elshatory, Y.M.; Kwon, Y.H.; Gehrs, K.M.; Boldt, H.C.; et al. Ocular hypertension after intravitreal dexamethasone (ozurdex) sustained-release implant. Retina 2017, 37, 1345–1351. [Google Scholar] [CrossRef]
- Zarranz-Ventura, J.; Sala-Puigdollers, A.; Velazquez-Villoria, D.; Figueras-Roca, M.; Copete, S.; Distefano, L.; Boixadera, A.; García-Arumi, J.; Adan, A. Long-term probability of intraocular pressure elevation with the intravitreal dexamethasone implant in the real-world. PLoS ONE 2019, 14, e0209997. [Google Scholar] [CrossRef] [Green Version]
- Srinivasan, R.; Sharma, U.; George, R.; Raman, R.; Sharma, T. Intraocular pressure changes after dexamethasone implant in patients with glaucoma and steroid responders. Retina 2019, 39, 157–162. [Google Scholar] [CrossRef]
- Goni, F.J.; Stalmans, I.; Denis, P.; Nordmann, J.P.; Taylor, S.; Diestelhorst, M.; Figueiredo, A.R.; Garway-Heath, D.F. Elevated Intraocular Pressure After Intravitreal Steroid Injection in Diabetic Macular Edema: Monitoring and Management. Ophthalmol. Ther. 2016, 5, 47–61. [Google Scholar] [CrossRef] [Green Version]
Characteristics. | Value |
---|---|
No. of patients | 49 |
No. of eyes | 49 |
Age, years (mean ± SD) | 55.1 ± 10.4 |
Sex, male/female (%) | 22/27 (45/55) |
Hypertension (%) | 16 (33) |
No. of prior intravitreal bevacizumab injections (mean ± SD) | 3.3 ± 3.4 |
Panretinal photocoagulation (%) | 25 (51) |
Best-corrected visual acuity, log MAR (mean ± SD) | 0.63 ± 0.48 |
Intraocular pressure, mmHg (mean ± SD) | 14.43 ± 3.01 |
Central macular thickness, μm (mean ± SD) | 538.9 ± 105.3 |
Diagnoses (n) | |
NPDR | 14 |
PDR | 15 |
BRVO | 14 |
CRVO | 6 |
Characteristics. | IIOP (n = 18) | nIIOP (n = 31) | p Value |
---|---|---|---|
Age, years (mean ± SD) | 51.89 ± 10.40 | 56.90 ± 10.04 | 0.103 * |
Sex, male/female (%) | 11/7 (61/39) | 11/20 (35/65) | 0.082 † |
Baseline | |||
BCVA, log MAR (mean ± SD) | 0.76 ± 0.53 | 0.56 ± 0.40 | 0.155 * |
IOP, mmHg (mean ± SD) | 15.06 ± 3.93 | 14.07 ± 2.31 | 0.339 * |
CST, μm (mean ± SD) | 574.44 ± 109.53 | 518.23 ± 98.67 | 0.071 * |
No. of patients treated with IOP lowering medication | 0 | 0 | |
1 week after IVDI | |||
BCVA, log MAR (mean ± SD) | 0.49 ± 0.32 | 0.44 ± 0.26 | 0.484 * |
IOP, mmHg (mean ± SD) | 20.89 ± 3.48 | 14.68 ± 3.29 | <0.001 * |
CST, μm (mean ± SD) | 367.33 ± 75.13 | 377.94 ± 56.58 | 0.578 * |
No. of patients treated with IOP lowering medication | 9 | 0 | <0.001 † |
1 month after IVDI | |||
BCVA, log MAR (mean ± SD) | 0.39 ± 0.33 | 0.42 ± 0.24 | 0.657 * |
IOP, mmHg (mean ± SD) | 21.28 ± 6.52 | 15.55 ± 4.75 | 0.001 * |
CST, μm (mean ± SD) | 343.78 ± 138.71 | 320.52 ± 74.87 | 0.448 * |
No. of patients treated with IOP lowering medication | 11 | 4 | 0.001 † |
3 months after IVDI | |||
BCVA, log MAR (mean ± SD) | 0.38 ± 0.35 | 0.53 ± 0.40 | 0.189 * |
IOP, mmHg (mean ± SD) | 16.94 ± 5.79 | 15.39 ± 3.50 | 0.245 * |
CST, μm (mean ± SD) | 394.39 ± 156.29 | 372.68 ± 108.68 | 0.570 * |
No. of patients treated with IOP lowering medication | 11 | 6 | 0.005 † |
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Kim, K.T.; Lee, H.; Kim, J.Y.; Chae, J.B.; Hyung, S.; Kim, D.Y. Association between Early Anatomic Response and Intraocular Pressure Change after Intravitreal Dexamethasone Implant: An Optical Coherence Tomography Study. J. Clin. Med. 2020, 9, 2692. https://doi.org/10.3390/jcm9092692
Kim KT, Lee H, Kim JY, Chae JB, Hyung S, Kim DY. Association between Early Anatomic Response and Intraocular Pressure Change after Intravitreal Dexamethasone Implant: An Optical Coherence Tomography Study. Journal of Clinical Medicine. 2020; 9(9):2692. https://doi.org/10.3390/jcm9092692
Chicago/Turabian StyleKim, Kyung Tae, Hwanho Lee, Jin Young Kim, Ju Byung Chae, Sungmin Hyung, and Dong Yoon Kim. 2020. "Association between Early Anatomic Response and Intraocular Pressure Change after Intravitreal Dexamethasone Implant: An Optical Coherence Tomography Study" Journal of Clinical Medicine 9, no. 9: 2692. https://doi.org/10.3390/jcm9092692