Risk Factors and Incidence of Elevated Intraocular Pressure after Dexamethasone Intravitreal Implant

Abstract

Purpose: To report the incidence of intraocular pressure (IOP) elevation and identify the risk factors of IOP elevation after intravitreal dexamethasone 0.7 mg (Ozurdex, Allergan, Irvine, CA, USA) implant. Methods: A total of 86 eyes of 79 patients who underwent intravitreal dexamethasone implantation and who were followed for ≥ 3 months were included in the present study. IOP elevation was defined as a pressure > 21 mm Hg at some time during follow-up. Results: Twenty-nine eyes (33.7%) had an IOP > 21 mm Hg after dexamethasone intravitreal implant. The incidence of IOP elevation increased rapidly at 2‒3 months after dexamethasone intravitreal implant. The Kaplan-Meier estimated incidence of IOP elevation was 25.6 ± 4.7% (mean ± standard error) at 81 days. Cox multivariate analysis showed the significant risk factors of IOP elevation to be age < 55 years (p = 0.045), baseline IOP ≥ 15 mm Hg (p < 0.001), and history of intraocular surgery (p = 0.039). Conclusions: This study demonstrates the incidence of IOP elevation to be 33.7% and describes the risk factors associated with IOP elevation. Clinicians should be cautious regarding the possibility of IOP elevation after intravitreal dexamethasone implant, especially in the presence of identified risk factors. J Korean Ophthalmol Soc 2016;57(9):1422-1429