Management of ocular hypertension following intravitreal dexamethasone implant (ozurdex)

Purpose: To evaluate the impact of intravitreal dexamethasone implantation (Ozurdex) on ocular hypertension (OHT) development and characterize its management with non-invasive or minimally-invasive modalities. Results: Chart review was performed for patients who received Ozurdex implantation between...

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Main Authors: Jason Xiao, Mary Qiu
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:American Journal of Ophthalmology Case Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2451993625000271
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author Jason Xiao
Mary Qiu
author_facet Jason Xiao
Mary Qiu
author_sort Jason Xiao
collection DOAJ
description Purpose: To evaluate the impact of intravitreal dexamethasone implantation (Ozurdex) on ocular hypertension (OHT) development and characterize its management with non-invasive or minimally-invasive modalities. Results: Chart review was performed for patients who received Ozurdex implantation between September 2016 to September 2023. Patients were excluded if they had ever been diagnosed with neovascular glaucoma or received a different intravitreal corticosteroid prior to Ozurdex injection or 6 months afterwards. The analysis included 171 Ozurdex implants (n = 61 patients, n = 74 eyes) for analysis. Patients were followed for an average of 326 ± 45 days. The rise in IOP was greatest 2- and 3-months post-injection. OHT occurred following 40 (23.3 %) Ozurdex implants. To lower IOP, medical drops were initiated after 17 (10.0 %) implants. Selective laser trabeculoplasty was performed in 2 (1.2 %) cases. Minimally-invasive glaucoma surgeries (MIGS) were utilized in 7 (4.1 %) cases. Patients >60 years old were at increased odds of developing OHT, whereas patients treated for retinal vein occlusion were less likely to develop OHT compared to patients treated for diabetic macular edema. Conclusion: Patient-specific characteristics, including age and treatment indication, may confer different risk for developing OHT following Ozurdex implantation. Ozurdex-induced OHT can be safely and effectively managed using a combination of medical therapy, laser trabeculoplasty, and angle-based MIGS. This study supports an increasing range of alternative approaches for addressing elevated IOP or postponing surgeries linked with higher risks.
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spelling doaj-art-4d8d4d9d265a48989727f3df0f5112c92025-08-20T03:53:46ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362025-06-013810227410.1016/j.ajoc.2025.102274Management of ocular hypertension following intravitreal dexamethasone implant (ozurdex)Jason Xiao0Mary Qiu1Department of Ophthalmology and Visual Science, University of Chicago, Chicago, IL, USADepartment of Ophthalmology and Visual Science, University of Chicago, Chicago, IL, USA; Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA; Corresponding author. Cleveland Clinic Foundation - Cole Eye Institute, 9500 Euclid Ave, Cleveland, OH, 44195, USA.Purpose: To evaluate the impact of intravitreal dexamethasone implantation (Ozurdex) on ocular hypertension (OHT) development and characterize its management with non-invasive or minimally-invasive modalities. Results: Chart review was performed for patients who received Ozurdex implantation between September 2016 to September 2023. Patients were excluded if they had ever been diagnosed with neovascular glaucoma or received a different intravitreal corticosteroid prior to Ozurdex injection or 6 months afterwards. The analysis included 171 Ozurdex implants (n = 61 patients, n = 74 eyes) for analysis. Patients were followed for an average of 326 ± 45 days. The rise in IOP was greatest 2- and 3-months post-injection. OHT occurred following 40 (23.3 %) Ozurdex implants. To lower IOP, medical drops were initiated after 17 (10.0 %) implants. Selective laser trabeculoplasty was performed in 2 (1.2 %) cases. Minimally-invasive glaucoma surgeries (MIGS) were utilized in 7 (4.1 %) cases. Patients >60 years old were at increased odds of developing OHT, whereas patients treated for retinal vein occlusion were less likely to develop OHT compared to patients treated for diabetic macular edema. Conclusion: Patient-specific characteristics, including age and treatment indication, may confer different risk for developing OHT following Ozurdex implantation. Ozurdex-induced OHT can be safely and effectively managed using a combination of medical therapy, laser trabeculoplasty, and angle-based MIGS. This study supports an increasing range of alternative approaches for addressing elevated IOP or postponing surgeries linked with higher risks.http://www.sciencedirect.com/science/article/pii/S2451993625000271Intravitreal corticosteroidsOcular hypertensionGlaucomaLaser trabeculoplastyMinimally invasive glaucoma surgery
spellingShingle Jason Xiao
Mary Qiu
Management of ocular hypertension following intravitreal dexamethasone implant (ozurdex)
American Journal of Ophthalmology Case Reports
Intravitreal corticosteroids
Ocular hypertension
Glaucoma
Laser trabeculoplasty
Minimally invasive glaucoma surgery
title Management of ocular hypertension following intravitreal dexamethasone implant (ozurdex)
title_full Management of ocular hypertension following intravitreal dexamethasone implant (ozurdex)
title_fullStr Management of ocular hypertension following intravitreal dexamethasone implant (ozurdex)
title_full_unstemmed Management of ocular hypertension following intravitreal dexamethasone implant (ozurdex)
title_short Management of ocular hypertension following intravitreal dexamethasone implant (ozurdex)
title_sort management of ocular hypertension following intravitreal dexamethasone implant ozurdex
topic Intravitreal corticosteroids
Ocular hypertension
Glaucoma
Laser trabeculoplasty
Minimally invasive glaucoma surgery
url http://www.sciencedirect.com/science/article/pii/S2451993625000271
work_keys_str_mv AT jasonxiao managementofocularhypertensionfollowingintravitrealdexamethasoneimplantozurdex
AT maryqiu managementofocularhypertensionfollowingintravitrealdexamethasoneimplantozurdex