2Doç. Dr., Kırıkkale Üniversitesi Tıp Fakultesi, Göz Hastalıkları, Kırıkkale, Türkiye
3Yrd. Doç. Dr., Kırıkkale Üniversitesi Tıp Fakultesi, Göz Hastalıkları, Kırıkkale, Türkiye
4Prof. Dr., Kudret Göz Hastanesi, Ankara, Türkiye Purpose: To investigate the effects of intravitreal dexamethasone injection on intraocular pressure (IOP) and anterior chamber angle (ACA).
Materials and Methods: Forty eyes of 38 patients were studied. The mean age of the patients was 61.39 years (range: 36-83), 63.2% female and 36.8% male. 70% were retinal vein occlusion, 20% were diabetic, 7.5% were posterior uveitis and 2.5% were pseudophakic macular edema. IOP was measured by Goldman applanation tonometry. IOP and gonioscopic examination were performed before and after injection on the 1st week 1st, 3rd, and 6th months. Spectral domain optic coherence tomography (OCT) was performed on the superior, nasal, inferior, temporal quadrants before and after injection on the 1st, 3rd, and 6th months. Anterior chamber angle (ACA), trabecular iris surface area (TISA500) and angle opening distance (AOD500) were measured by OCT.
Results: The mean IOP at baseline was signifi cantly lower than the mean IOP in first week, fi rst month and third months after injections (p= 0.004, p= 0.002, p= 0.003). There was no signifi cant difference between the mean IOP in sixth months after injection and the mean IOP at baselıne. The gonioscopic grade at baseline and at the 1st week after injection were signifi - cantly higher than gonioscopic grade at the 3rd and 6th months after injection in the nasal quadrant (p= 0.007, p= 0.006, p= 0.008, p= 0.008). No signifi cant difference was found for gonioscopy in other quadrants. In nasal quadrant the values of OCT-ACA at 3th and 6th months post-injection were signifi cantly narrower than the values of OCT-ACA at baseline and 1st month post-injection (p= 0.008, p= 0.008, p= 0.009, p= 0.008). Because of eyelid no reliable measurement was obtained in superior quadrant. The values of OCT-AOD500 and TISA500 at the 3rd and 6th months post-injection were signifi cantly lower than the values of OCTAOD500 and TISA500 at baseline in the inferior quadrant (p= 0.002, p= 0.004, p= 0.005, p= 0.001).
Conclusion: Intraocular pressures may increase after intravitreal dexamethasone injection, But most cases may be controlled by medical treatment. After injection anterior chamber angle can be narrowed in some quadrants by OCT and gonioscopy.
Keywords : Intravitreal dexamethasone implant, intraocular pressure, anterior chamber angle, gonioscopy