Predicting the safety zone for steroid-induced ocular hypertension induced by intravitreal dexamethasone implantation

Wungrak Choi, Hyoung Won Bae, Hye Jung Shin, Eun Woo Kim, Chan Yun Kim, Min Kim, Gong Je Seong

Research output: Contribution to journalArticlepeer-review


Background/aims This study aimed to predict the possibility of steroid-induced ocular hypertension (OHT) after intravitreal dexamethasone (DEX) implantation and to identify a proper safety zone for such injections. Methods A cross-sectional observational study was conducted and included 908 patient eyes that underwent DEX implant injection due to various retinal diseases. Intraocular pressure (IOP) was measured before injection, at 1 week, and at 1, 2, 3, 6 and 12 months thereafter. Eyes of enrolled patients were divided into the OHT and normal IOP groups. Univariable logistic regression analysis was used to assess significant associations between steroid-induced OHT and covariates; significant and previously reported significant variables were analysed with a multivariable model, and predictive nomograms were developed. Results Age, sex, axial length, glaucomatous eye, neovascular glaucoma, secondary glaucoma, uveitis history, hypertension, depression, diabetes mellitus and a history of previous laser-assisted in-situ keratomileusis or laser-assisted subepithelial keratectomy were significantly related to steroid-induced OHT (p<0.05). The calibration plot revealed good prediction under a predicted value of 0.4. Cut-off values for 80%, 86%, 91%, 95% and 98% sensitivity and specificity were offered for the safety zone after intravitreal DEX implantation. Conclusion We developed two nomograms to predict a safety zone for intravitreal DEX implantation. These can be used to identify individuals who may be safely prescribed steroid treatments and for whom extra caution should be exercised.

Original languageEnglish
Pages (from-to)1150-1156
Number of pages7
JournalBritish Journal of Ophthalmology
Issue number8
Publication statusPublished - 2022 Aug 1

Bibliographical note

Funding Information:
Funding This work was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF-2019 R1I1A1A01061721 and NRF-2019 R1G1A1008122) and by a faculty research grant of Yonsei University College of Medicine (6-2020-0139).

Publisher Copyright:

All Science Journal Classification (ASJC) codes

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience


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