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Ozurdex implant tolerated well, with IOP spikes transient and treatable
A retrospective real-life study of patients treated with the Ozurdex dexamethasone implant for various indications showed overall good tolerance and provided useful information on risk factors for pressure elevation.
Four hundred twenty-one eyes of 361 patients were analyzed in the SAFODEX study. They received 1,000 injections for macular edema secondary to retinal vein occlusion, diabetic macular edema, postsurgical macular edema, uveitis and other etiologies. Pre-existing ocular hypertension or glaucoma was present in 14% of eyes. Re-treatment was required in 58% of eyes, and one-third of the patients received at least three Ozurdex implants (Allergan).
Ocular hypertension was reported in 28.5% of the eyes over the follow-up, with an IOP increase of more than 10 mm Hg in 27% of eyes. The percentage of patients developing ocular hypertension was higher in the uveitis and retinal vein occlusion groups as compared with the DME group. Ocular hypertension was most frequently diagnosed at 2 months, with a minority of patients developing it as early as day 8 or as late as 3 months.
IOP elevation was managed with topical treatment in 97% of cases. The subgroup of patients with ocular hypertension or glaucoma at baseline showed poor pressure tolerance to dual or triple therapy. Three patients with glaucoma required surgical intervention.
Re-treatment after 3 to 4 months did not result in increased risk for IOP elevation, and the number of patients with ocular hypertension decreased over the follow-up despite repeated treatments. However, as the authors noted, “patients who developed elevated IOP after the first injection often received prophylactic pressure-lowering therapy when subsequent injections were administered, which certainly also limited increases in IOP on re-treatment.” – by Michela Cimberle
Disclosures: Malclès reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.