Intravitreal Sustained Release Steroid Implants Are Safe and Effective in Patients With Glaucoma Drainage Devices.

IF 2.3 2区医学 Q2 OPHTHALMOLOGY Retina-The Journal of Retinal and Vitreous Diseases Pub Date : 2025-01-07 DOI:10.1097/IAE.0000000000004396

Henry W Zhou, Rachel Tandias, Edward S Lu, Sandra Hoyek, Michael M Lin, John B Miller, David Solá-Del Valle, Nimesh A Patel

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Abstract

Purpose: To describe effects of sustained-release steroid delivery devices on intraocular pressure (IOP) in eyes with glaucoma drainage devices (GDD).

Methods: Retrospective case series of eyes with steroid implants (dexamethasone or fluocinolone acetonide) and prior GDD (Ahmed, Baerveldt) without uveitis. Outcomes included IOP, IOP rise, central foveal thickness (CFT), and IOP medications.

Results: We included 14 eyes (14 patients, 38% male, 94% pseudophakic). Mean age at steroid implantation was 64 ± 12 years. Baerveldt (64%) was more common than Ahmed (36%). Tubes were in the anterior chamber (57.1%), sulcus (28.6%), and pars plana (14.3%). Ozurdex (93%) was more common than Yutiq (7%). Mean IOP was 13.5 ± 3.4 mmHg pre-implant, 11.8 ± 3.7 mmHg at month 1, 13.3 ± 3.6 mmHg at month 3 (p=0.35), and 11.3 ± 3.8 mmHg at 1 year (p=0.032). Mean antihypertensive medications was unchanged at month 3 (p = 1.0), and -0.36 medications at last follow-up (p = 0.35). Mean CFT change was -204 ± 158 μm (p = 0.001). There were no cases of endophthalmitis.

Conclusions: Intravitreal steroid implants were safe and effective for the treatment of post-surgical CME in patients with pre-existing GDD. There was no increase in IOP and no increase in antihypertensive drops.

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玻璃体内缓释类固醇植入治疗青光眼引流装置安全有效。

目的：观察缓释类固醇给药装置对青光眼引流装置（GDD）患者眼压（IOP）的影响。方法：回顾性研究使用类固醇植入物（地塞米松或醋酸氟西诺酮）且既往GDD （Ahmed, Baerveldt）且无葡萄膜炎的眼睛病例系列。结果包括IOP、IOP升高、中央中央凹厚度（CFT）和IOP药物。结果：纳入14只眼（14例，男性38%，假性晶状体94%）。类固醇植入的平均年龄为64±12岁。Baerveldt（64%）比Ahmed（36%）更常见。导管位于前房（57.1%）、沟（28.6%）和平面部（14.3%）。Ozurdex（93%）比Yutiq（7%）更常见。平均IOP为植入前13.5±3.4 mmHg，第1个月11.8±3.7 mmHg，第3个月13.3±3.6 mmHg (p=0.35)， 1年后11.3±3.8 mmHg （p=0.032）。平均降压药物在第3个月时没有变化（p = 1.0），在最后一次随访时-0.36药物（p = 0.35）。平均CFT变化为-204±158 μm （p = 0.001）。无眼内炎病例。结论：玻璃体内类固醇植入治疗既往GDD患者术后CME安全有效。眼压没有升高，抗高血压药滴度也没有升高。

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来源期刊

Retina-The Journal of Retinal and Vitreous Diseases 医学-眼科学

CiteScore

5.70

自引率

9.10%

发文量

554

审稿时长

3-6 weeks

期刊介绍： RETINA® focuses exclusively on the growing specialty of vitreoretinal disorders. The Journal provides current information on diagnostic and therapeutic techniques. Its highly specialized and informative, peer-reviewed articles are easily applicable to clinical practice. In addition to regular reports from clinical and basic science investigators, RETINA® publishes special features including periodic review articles on pertinent topics, special articles dealing with surgical and other therapeutic techniques, and abstract cards. Issues are abundantly illustrated in vivid full color. Published 12 times per year, RETINA® is truly a “must have” publication for anyone connected to this field.