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Baseline intraocular pressure: an independent risk factor in severe steroid-induced ocular hypertension after intravitreal dexamethasone implant

  • Glaucoma
  • Published:
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Abstract

Purpose

To evaluate the baseline intraocular pressure (IOP)-related risk of severe steroid-induced ocular hypertension (SIOH). We hypothesized that the incidence and severity of SIOH may differ according to baseline IOP in patients who received intravitreal dexamethasone implants.

Methods

A total of 889 eyes treated with intravitreal dexamethasone implants and a baseline IOP of ≤ 23 mmHg were enrolled. Enrolled patients were divided into two groups: the steroid-responders (127 eyes) and the non-steroid-responders (762 eyes). The steroid-responders group was subdivided into post-injection IOP of ≥ 25, > 30, or > 35 mmHg or IOP elevation of ≥ 10 mmHg over the baseline value. The odds ratio of SIOH was calculated using univariable logistic regression analysis, and significant variables were analyzed with a multivariable model. IOP was measured before (baseline IOP) and after dexamethasone implant injection at 1 week and 1, 2, 3, 6, and 12 months.

Results

Although baseline IOP was significantly associated with the development of SIOH in logistic regression analysis, the results from the subgroup analysis differed. In the group with IOP elevation of ≥ 10 mmHg over the baseline, SIOH was not significantly associated with baseline IOP, but it was significantly related to higher baseline IOP in the severe SIOH group (IOP > 30 and > 35 mmHg).

Conclusions

Higher baseline IOP is a risk factor for severe SIOH. Clinicians should be aware of the risk of SIOH when administering steroids intravitreally to patients with high baseline IOP (IOP > 19 mmHg).

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

IOP:

Intraocular pressure

SIOH:

Steroid-induced ocular hypertension

POAG:

Primary open-angle glaucoma

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Acknowledgements

Statistical analyses were performed by statistics expert Hye Jung Shin from the Biostatistics Collaboration Unit in the Department of Biomedical Systems Informatics of Yonsei University College of Medicine.

Funding

This work was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF-2022R1I1A1A01071919) by 2022 Cheil-Nammyung Foundation Research Funds, and by new faculty research seed money grant of Yonsei University College of Medicine for 2023 (2023–32-0059). The funding organization had no role in the design or conduct of this research.

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Authors and Affiliations

  1. Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea

    Won Jeong Cho, Hyoung Won Bae, Chan Yun Kim, Gong Je Seong & Wungrak Choi

  2. Siloam Eye Hospital, Seoul, Korea

    Jun Mo Lee

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  1. Won Jeong Cho
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Contributions

Won Jeong Cho, Jun Mo Lee, Hyoung Won Bae, Gong Je Seong, and Wungrak Choi conceived the design of the study. Wungrak Choi, Chan Yun Kim, and Gong Je Seong collected the data. Won Jeong Cho, Wungrak Choi, Chan Yun Kim analyzed and interpreted the data. Won Jeong Cho, Wungrak Choi, Gong Je Seong, and Hyoung Won Bae drafted the article. Won Jeong Cho, Jun Mo Lee, Wungrak Choi, Gong Je Seong, and Chan Yun Kim critically revised the article. All authors read and approved the final version of the article to be published.

Corresponding author

Correspondence to Wungrak Choi.

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Ethical approval

This study was approved by the Gangnam Severance Hospital Institutional Review Board (IRB number: 3–2020-0342). The study protocol adhered to the tenets of the Declaration of Helsinki and complied with the Health Insurance Portability and Accountability Act.

Informed consent

Since the study was a retrospective review of existing patient records, the requirement for informed consent was waived.

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The authors declare that they have no conflict of interest.

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Cho, W.J., Lee, J.M., Bae, H.W. et al. Baseline intraocular pressure: an independent risk factor in severe steroid-induced ocular hypertension after intravitreal dexamethasone implant. Graefes Arch Clin Exp Ophthalmol 262, 1231–1243 (2024). https://doi.org/10.1007/s00417-023-06299-4

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  • DOI: https://doi.org/10.1007/s00417-023-06299-4

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