본문 바로가기
KERD
논문KCI 등재

Axial Length as a Risk Factor for Steroid-Induced Ocular Hypertension

0

조회

0

다운로드

1

인용

0

참고문헌

키워드

주제분류의학일반

초록

Purpose: In this study, we aimed to assess whether axial length (AXL) is a true risk factor for steroid-induced ocular hypertension(OHT). We hypothesized that the proportion of patients with steroid-induced OHT among individuals who have received intra-vitreal dexamethasone (DEX) injections would differ according to the AXL of their eyes. Materials and Methods: A single-center, cross-sectional, case-control study was conducted on 467 eyes that underwent DEX im-plant injection owing to various retinal diseases. Intraocular pressure (IOP) was measured before the injection and 1 week and 1,2, 3, 6, and 12 months after the injection. Enrolled patients were divided into OHT and normal IOP groups. Univariable logistic re-gression analysis was used to calculate odds ratios of steroid-induced OHT with significant variables being analyzed using a multi-variable model. Results: A longer AXL was identified as a risk factor for steroid-induced OHT via both univariable and multivariable analyses, withan odds ratio of 1.216 [95% confidence interval (CI): 1.004–1.472, p=0.0452]. The optimal cut-off value for AXL in terms of steroid-induced OHT was 23.585 mm, with an odds ratio of 2.355 (95% CI: 1.429–3.882, p=0.0008). Conclusion: Our findings indicate that a long AXL is a risk factor for steroid-induced OHT. Further, clinicians should be aware ofsteroid-induced OHT when treating patients with high myopia with steroids.

Abstract

Purpose: In this study, we aimed to assess whether axial length (AXL) is a true risk factor for steroid-induced ocular hypertension(OHT). We hypothesized that the proportion of patients with steroid-induced OHT among individuals who have received intra-vitreal dexamethasone (DEX) injections would differ according to the AXL of their eyes. Materials and Methods: A single-center, cross-sectional, case-control study was conducted on 467 eyes that underwent DEX im-plant injection owing to various retinal diseases. Intraocular pressure (IOP) was measured before the injection and 1 week and 1,2, 3, 6, and 12 months after the injection. Enrolled patients were divided into OHT and normal IOP groups. Univariable logistic re-gression analysis was used to calculate odds ratios of steroid-induced OHT with significant variables being analyzed using a multi-variable model. Results: A longer AXL was identified as a risk factor for steroid-induced OHT via both univariable and multivariable analyses, withan odds ratio of 1.216 [95% confidence interval (CI): 1.004–1.472, p=0.0452]. The optimal cut-off value for AXL in terms of steroid-induced OHT was 23.585 mm, with an odds ratio of 2.355 (95% CI: 1.429–3.882, p=0.0008). Conclusion: Our findings indicate that a long AXL is a risk factor for steroid-induced OHT. Further, clinicians should be aware ofsteroid-induced OHT when treating patients with high myopia with steroids.

참고문헌 (22)

  1. Fini ME, "Steroid-induced ocular hypertension", glaucoma : focus on pharmacogenomics and implications for precision medicine, 2017, pp.56, 58~83
  2. Podos SM, "High myopia and primary openangle glaucoma", Am J Ophthalmol, 62, pp.1039~1043 (1966)
  3. Choi MY, "Risk factors for ocular hypertension after intravitreal dexamethasone implantation in diabetic macular edema", Sci Rep, 10, pp.13736~ (2020)
  4. Choi W, "Intraocular pressure change after injection of intravitreal dexamethasone(Ozurdex)implant in Korean patients", Br J Ophthalmol, 103, pp.1380~1387 (2019)
  5. Choi W, "Age as a risk factor for steroid-induced ocular hypertension in the non-paediatric population", Br J Ophthalmol, 104, pp.1423~1429 (2020)
  6. Phulke S, "Steroid-induced glaucoma : an avoidable irreversible blindness", J Curr Glaucoma Pract, 11, pp.67~72 (2017)
  7. Kass MA, "The ocular hypertension treatment study : a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma", Arch Ophthalmol, 120, pp.701~713 (2002)
  8. Armaly MF, "Effect of corticosteroids on intraocular pressure and fluid dynamics. I. The effect of dexamethasone in the normal eye", Arch Ophthalmol, 70, pp.482~491 (1963)
  9. Armaly MF, "Effect of corticosteroids on intraocular pressure and fluid dynamics. II. The effect of dexamethasone in the glaucomatous eye", Arch Ophthalmol, 70, pp.492~499 (1963)
  10. Becker B, "Topical corticosteroids and heredity in primary open-angle glaucoma", Am J Ophthalmol, 57, pp.543~551 (1964)
  11. Davies TG, "Tonographic survey of the close relatives of patients with chronic simple glaucoma", Br J Ophthalmol, 52, pp.32~39 (1968)
  12. Lam DS, "Ocular hypertensive and anti-inflammatory responses to different dosages of topical dexamethasone in children : a randomized trial", Clin Exp Ophthalmol, 33, pp.252~258 (2005)
  13. Gaston H, "Steroid responsiveness in connective tissue diseases", Br J Ophthalmol, 67, pp.487~490 (1983)
  14. Malclès A, "Safety of intravitreal dexamethasone implant(Ozurdex) : the SAFODEX study. Incidence and risk factors of ocular hypertension", Retina, 37, pp.1352~1359 (2017)
  15. Hsu CH, "Myopia and glaucoma : sorting out the difference", Curr Opin Ophthalmol, 26, pp.90~95 (2015)
  16. Kimura Y, "Lamina cribrosa defects and optic disc morphology in primary open angle glaucoma with high myopia", PLoS One, 9, pp.e115313~ (2014)
  17. 윤주영, "Progressive Optic Disc Tilt in Young Myopic Glaucomatous Eyes", Korean Journal of Ophthalmology, 33(6), pp.520~527 (2019), 대한안과학회[DOI]
  18. Chen Z, "Schlemm’s canal and trabecular meshwork morphology in high myopia", Ophthalmic Physiol Opt, 38, pp.266~272 (2018)
  19. D’Ermo F, "Permeability of the blood-aqueous barrier in myopic subjects having chronic glaucoma", Boll Ocul, 34, pp.98~108 (1955)
  20. Boyer DS, "Three-year, randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with diabetic macular edema", Ophthalmology, 121, pp.1904~1914 (2014)
  21. Haller JA, "Randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with macular edema due to retinal vein occlusion", Ophthalmology, 117, pp.1134~1146.e3 (2010)
  22. Erkan Unsal, "Efficacy and Safety of Intravitreal Dexamethasone Implants for Treatment of Refractory Diabetic Macular Edema", Korean Journal of Ophthalmology, 31(2), pp.115~122 (2017), 대한안과학회

관련 논문AI추천

이 간행물의 다른 논문 (9건)