Use of selective laser trabeculoplasty as an alternative in patients who developed ocular hypertension after intravitreal dexamethasone implants: a series of 35 eyes.

Autor: Billant J; Department of Ophthalmology, Desgenettes Military Hospital, 108 boulevard Pinel, Lyon, 69003, France. billant.jeremy@gmail.com., Agard E; Department of Ophthalmology, Desgenettes Military Hospital, 108 boulevard Pinel, Lyon, 69003, France., Douma I; Department of Ophthalmology, Desgenettes Military Hospital, 108 boulevard Pinel, Lyon, 69003, France., Levron A; Department of Ophthalmology, Desgenettes Military Hospital, 108 boulevard Pinel, Lyon, 69003, France., Brunet O; Department of Ophthalmology, Desgenettes Military Hospital, 108 boulevard Pinel, Lyon, 69003, France., Remignon CH; Department of Ophthalmology, Desgenettes Military Hospital, 108 boulevard Pinel, Lyon, 69003, France., Sejournet L; Department of Ophthalmology, Desgenettes Military Hospital, 108 boulevard Pinel, Lyon, 69003, France., Dot C; Department of Ophthalmology, Desgenettes Military Hospital, 108 boulevard Pinel, Lyon, 69003, France.; French Military Health Service Academy, Val de Grâce, Paris, France.
Jazyk: angličtina
Zdroj: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie [Graefes Arch Clin Exp Ophthalmol] 2022 Nov; Vol. 260 (11), pp. 3665-3673. Date of Electronic Publication: 2022 Jun 04.
DOI: 10.1007/s00417-022-05725-3
Abstrakt: Purpose: Steroid-induced ocular hypertension (OHT) occurs in about a third of cases after dexamethasone implant (DEXi) intravitreal injection (IVI), for which treatment discontinuation may be required. The aim of this study was to assess the benefit of selective laser trabeculoplasty (SLT) in patients who developed transient OHT after DEXi injection to prevent subsequent steroid-induced OHT peaks during reinjections.
Methods: A real-life, retrospective, and observational study was conducted to assess the intraocular pressure (IOP) after SLT in steroid responders after DEXi injection (IOP > 21 mmHg). Were analyzed: IOP 1 and 2 months after SLT, maximum IOP (IOP max ) after each new DEXi IVI, and the number of prophylactic hypotensive treatments needed at the time of DEXi reinjections.
Results: Thirty-five eyes of 29 patients were included. The mean macular edema follow-up duration was 38.4 ± 28.4 months. SLT was performed after a mean number of 6.3 ± 4.7 DEXi IVIs. After SLT, the IOP max measured after the first reinjection was lowered by 36.6 ± 14.7% (p < 0.0001). The mean number of hypotensive treatments was 2.1 ± 0.9 before versus 1.5 ± 0.8 after SLT. The post-reinjection lowering in OHT peak was maintained during the subsequent 3 DEXi IVIs: - 29.1 ± 25.5% (p = 0.0009), - 35.8 ± 13.1% (p = 0.0078), and - 45.4 ± 8.6% (p = 0.0312) after the second, third, and fourth DEXi reinjections. SLT allowed continuing injections in 88.6% of patients.
Conclusion: The use of 180° SLT in this indication could be an effective therapeutic alternative to control steroid-induced OHT and safely continue DEXi injections.
(© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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