University of Surrey

Test tubes in the lab Research in the ATI Dance Research

Elevated Intraocular Pressure After Intravitreal Steroid Injection in Diabetic Macular Edema: Monitoring and Management

Goni, FJ, Stalmans, I, Denis, P, Nordmann, JP, Taylor, SRJ, Diestelhorst, M, Figueiredo, AR and Garway-Heath, DF (2016) Elevated Intraocular Pressure After Intravitreal Steroid Injection in Diabetic Macular Edema: Monitoring and Management Ophthalmology and Therapy.

[img]
Preview
Text
2016c Treatment of steroid-induced ocular hypertension in the management of diabetic macular oedema.pdf - Version of Record
Available under License : See the attached licence file.

Download (491kB) | Preview
[img]
Preview
PDF (licence)
SRI_deposit_agreement.pdf
Available under License : See the attached licence file.

Download (33kB) | Preview

Abstract

Introduction: With the increasing use of intravitreal administration of corticosteroids in macular edema, steroid-induced intraocular pressure (IOP) rise is becoming an emergent issue. However, for patients in whom intravitreal steroids are indicated, there are no specific recommendations for IOP monitoring and management after intravitreal administration of corticosteroids. Method: An expert panel of European ophthalmologists reviewed evidence on corticosteroid-induced IOP elevation. The objective of the panel was to propose an algorithm based on available literature and their own experience for the monitoring and management of corticosteroid-induced IOP elevation, with a focus on diabetic patients. Results: Data from trials including diabetic patients with a rise of IOP after intravitreal steroid administration indicate that IOP-lowering medical treatment is sufficient for a large majority of patients; only a small percentage underwent laser trabeculoplasty or filtering filtration surgery. A 2-step algorithm is proposed that is based on the basal value of IOP and evidence for glaucoma. The first step is a risk stratification before treatment. Patients normotensive at baseline (IOP B 21 mmHg), do not require additional baseline diagnostic tests. However, patients with baseline ocular hypertension (OHT) (IOP[21 mmHg) should undergo baseline imaging and visual field testing. The second step describes monitoring and treatment after steroid administration. During follow-up, patients developing OHT should have baseline and periodical imaging and visual field testing; IOP-lowering treatment is proposed only if IOP is [25 mmHg or if diagnostic tests suggest developing glaucoma. Conclusion: The management and follow-up of OHT following intravitreal corticosteroid injection is similar to that of primary OHT. If OHT develops, IOP is controlled in a large proportion of patients with standard IOP treatments. The present algorithm was developed to assist ophthalmologists with guiding principles in the management of corticosteroid-induced IOP elevation.

Item Type: Article
Subjects : Biosciences
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Authors :
AuthorsEmailORCID
Goni, FJUNSPECIFIEDUNSPECIFIED
Stalmans, IUNSPECIFIEDUNSPECIFIED
Denis, PUNSPECIFIEDUNSPECIFIED
Nordmann, JPUNSPECIFIEDUNSPECIFIED
Taylor, SRJUNSPECIFIEDUNSPECIFIED
Diestelhorst, MUNSPECIFIEDUNSPECIFIED
Figueiredo, ARUNSPECIFIEDUNSPECIFIED
Garway-Heath, DFUNSPECIFIEDUNSPECIFIED
Date : 10 May 2016
Identification Number : 10.1007/s40123-016-0052-8
Copyright Disclaimer : The Author(s) 2016. This article is published with open access at Springerlink.com
Related URLs :
Depositing User : Symplectic Elements
Date Deposited : 03 Jun 2016 10:51
Last Modified : 03 Jun 2016 10:51
URI: http://epubs.surrey.ac.uk/id/eprint/810912

Actions (login required)

View Item View Item

Downloads

Downloads per month over past year


Information about this web site

© The University of Surrey, Guildford, Surrey, GU2 7XH, United Kingdom.
+44 (0)1483 300800