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Br J Ophthalmol. 2019 Apr 30. pii: bjophthalmol-2019-313991. doi: 10.1136/bjophthalmol-2019-313991. [Epub ahead of print]

Safety of 6000 intravitreal dexamethasone implants.

Author information

1
Khoo Teck Puat Hospital, Singapore, Singapore.
2
Hospital Clínic de Barcelona Insi, Instituto Clinic de Barcelona, Instituto Clinic de Oftalmología (ICOF), Barcelona, Spain.
3
Department of Ophthalmology, Westmead Hospital, Sydney, Australian Capital Territory, Australia.
4
Save Sight Institute, Sydney Eye Hospital, University of Sydney, Sydney, New South Wales, Australia.
5
Department of Ophthalmology, Universitatsklinikum Leipzig, Leipzig, Germany.
6
Vitreo-retina, L V Prasad Eye Institute, Hyderabad, Andhra Pradesh, India.
7
Ophthalmology, Instituto de Oftalmología y Ciencias Visuales, Escuela de Medicina, Tecnológico de Monterrey, San Pedro Garza García, Mexico.
8
Department of Medicine-Ophthalmology, University of Udine, Udine, Italy.
9
11 Department of Ophthalmology, Command Hospital, Lucknow, India.
10
Dokuz Eylul University, Izmir, Turkey.
11
13 Ophthalmology Department, Hospital Universitario La Fe, Valencia, Spain.
12
Ophthalmology, Ospedale San Raffaele, Milano, Italy.
13
Ophthalmology, Federal University of Sao Paulo, Sao Paulo, Brazil.
14
University of Udine, Udine, Italy.
15
Retina and Vitreous, Clinica Oftalmologica Centro Caracas, Caracas, Venezuela.
16
Ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, Lyon, France.
17
CNRS UMR 5510 Mateis, University of Lyon, Lyon, France.
18
Vitreo-retina, L V Prasad Eye Institute, Hyderabad, Andhra Pradesh, India jay.chhablani@gmail.com.

Abstract

PURPOSE:

To evaluate the real-life safety profile of intravitreal dexamethasone implant injection for various retinal conditions.

METHODS:

Retrospective multicenter analysis of intravitreal dexamethasone implant injections (700 µg) due to various retinal conditions including central retinal venous occlusion (1861 injections), diabetic macular oedema (3104 injections), post-surgical cystoid macular oedema (305 injections) and uveitis (381 injections). The eyes were evaluated mainly for the occurrence of adverse events such as glaucoma, cataract, retinal detachment and endophthalmitis along during the follow-up period.

RESULTS:

A total of 6015 injections in 2736 eyes of 1441 patients (mean age of 65.7±12.9 years) were in total analysed over an average period of 18 months (range 6 months to 102 months). A total of 576 eyes (32.5% of the phakic eyes) developed cataract requiring surgical intervention. However, visually insignificant cataract progression was observed in another 259 phakic eyes (14.6%) which did not require surgical removal. A total of 727 eyes (26.5%) experienced an intraocular pressure (IOP) rise of >25 mm Hg, with 155 eyes (5.67%) having a prior history of glaucoma and 572 eyes (20.9%) having new onset IOP rise. Overall, more than 90% of eyes with IOP rise were managed medically, and 0.5% eyes required filtering surgery. Endophthalmitis (0.07%), retinal detachment (0.03%) and vitreous haemorrhage (0.03%) were rare. There was no significant change in visual acuity (p=0.87) and central macular thickness (p=0.12) at the last follow-up.

CONCLUSION:

This is the largest real-life study assessing the safety of intravitreal dexamethasone implant injections in various retinal conditions. Cataract progression and intraocular pressure rise are the most common side effects, but are often rather easily manageable.

KEYWORDS:

drugs; treatment medical; vision; vitreous

Conflict of interest statement

Competing interests: BR: None JZ-V: Allergan (Consultant); Bayer (Consultant); ATF: Allergan (Consultant); Bayer (Consultant); CB: Allergan (Consultant); Bayer (Travel support); Novartis (Consultant) NKS: None PJR-V: Allergan, Alcon, Novartis, Bayer, Industrial Organica, SA de CV, Laboratorios Sophia VS: None SKM: None AOS: Allergan (Consultant); Bayer (Consultant); Novartis (Consultant) PUM: Bayer (Consultant); Centervue (Consultant); Novartis (Consultant) GQ: Allergan, Alcon, Novartis, Bayer, Industrial Organica, SA de CV, Laboratorios Sophia. MEF: None PL: Alcon (Consultant); Alimera (Consultant); Allergan (Consultant); Bausch&Lomb (Consultant); Bayer (Consultant); Boehringer (Consultant); CenterVue (Consultant); Genentech (Consultant); Lupin (Consultant); Lutronic (Consultant); Novartis Pharma AG (Consultant); Roche (Consultant); Teva (Consultant); Topcon (Consultant) JFA: TURING PHARMACEUTICALS LLC(Consultant); DORC International B.V. (Consultant); Allergan Inc. (Consultant); Bayer (Consultant); Mallinckrodt (Consultant); TOPCON (Grant Support) LK: Principal Investigator for trials sponsored by Novartis, Allergan, Bayer, Théa, Alcon; has sat on advisory boards for Alcon, Alimera, Allergan, Bayer, Roche, Novartis; lecture fees from Alcon, Alimera, Allergan, Bayer, Horus, Novartis, Théa. JC: Allergan (Consultant); Bayer (Consultant); Novartis (Consultant); OD-OS (Consultant).

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