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Effects of the dexamethasone intravitreal implant (Ozurdex) on intraocular pressure for the treatment of macular edema

Purpose: To analyze the effects on intraocular pressure (IOP) of the sustained-release dexamethasone implant (Ozurdex, Allergan Inc., Irvine, CA, USA) for the treatment of macular edema. Methods: Retrospective study of patients receiving at least one dose of the sustained-release dexamethasone implant between January 2012 and June 2016 in the private retinal practice of a referral center in Barranquilla, Colombia. Ocular hypertension was defined as an IOP ≥ 21 mmHg or an increase of at least 10 mmHg from baseline. The monthly change in IOP during 6 months of follow-up and the relationship with a previous diagnosis of glaucoma was evaluated. Results: Thirty-seven cases were reviewed, with an initial IOP between 9 and 22 mmHg. Hypertension during the 6 months of follow up with topical antihypertensive requirement was observed in 21 cases (56.7%). In 11 cases (29.7%) IOP increased to ≥ 21 mmHg, in 6 (16.2%) it increased ≥ 25 mmHg and, in four cases to ≥ 10 mmHg (10.8%) above the baseline IOP after the 1st month. Likewise, after the 1st month there was an average variation of 3.8 ± 6 mmHg (p = 0.001) and of 1.67 ± 5.6 mmHg (p = 0.002) after the 2nd month. There were no statistical differences in patients with and without previous glaucoma. The highest increase in IOP at the first month was observed in cases with edema due to central serous chorioretinopathy (CSC) and Vogt-Koyanagi-Harada (VKH), with a mean of 23 and 21 mmHg respectively; however, this was not statistically significant. Conclusion: A large percentage of patients receiving Ozurdex® have ocular hypertension (56.7%), requiring management with topical antihypertensive drugs, independently of the history of glaucoma and the etiology of the edema. The highest increase occurred at the 1st month of treatment, remaining at the 2nd and 4th months, with a lower significance in the 6th month after treatment.