Diabetic retinopathy impact on intraocular pressure during corticosteroid therapy

Abstract

Purpose. Evaluation the impact of various types of diabetes mellitus, diabetic retinopathy and frequency of IVI injections of Ozurdex® on ophthalmic hypertension and its correction. Material and methods. 179 intravitreal injections of Ozurdex® in 148 patients (men – 66, women – 82) at the age of 53.5 (39/69) years have been performed. 123 patients (123 eyes) have undergone one surgery, 25 patients (25 eyes) have undergone two or more surgeries. The patients have been divided according to the types of diabetes and stages of retinopathy: non-proliferative diabetic retinopathy 19.5%, preproliferative diabetic retinopathy 44%, proliferative diabetic retinopathy 36.5% of patients, respectively. IOP level has been investigated before IVI, the next day, and 1 month after injection. In cases of ocular hypertension, local carbonic anhydrase inhibitors were used both mono and in combination with betaadrenoblockers according to the standard scheme.Results. Ophthalmic hypertension has been detected in 33% of patients, after the first injection in 91% of cases, and after the second injection in 9% of cases, and has been stabilized with medication. Patients who have undergone laser photocoagulation did not require combined drug therapy. The mean values of the ophthalmotonus of all patients tended to decrease (p<0.01). Cataract has been diagnosed in 57% of cases, phacoemulsification after the first IVI has been performed in 7%, and in 15% of cases after the second injection. The correlation coefficient between the IOP level before and after treatment was r = –0.0221. There was no statistical relationship between the development of ophthalmic hypertension and the number of Ozurdex® injections received. Conclusion. The rise in intraocular pressure, after the intravitreal injection of the Ozurdex® implant, is diagnosed 10% more often in patients with type I diabetes and in 54% of cases it was the share of preproliferative diabetic retinopathy. Ophthalmic hypertension was amenable to drug therapry within 3–11 months and compensated independently in half of patients. No correlation between hypertension and the number of Ozurdex® injections was found.

Keywords

• macular edema
• intraocular pressure
• endovitreal treatment
• intravitreal biodegradable dexamethasone implant (dexdds)