Intraocular pressure elevation after subtenon triamcinolone acetonide injection; Multicentre retrospective cohort study in Japan
Intraocular pressure elevation after subtenon triamcinolone acetonide injection; Multicentre retrospective cohort study in Japan
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DOI：
10.1371/journal.pone.0226118
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发表时间：
2019-12-05
期刊：
影响因子：
3.7
通讯作者：
Gomi, Fumi
中科院分区：
文献类型：
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作者：
Maeda, Yuki;Ishikawa, Hiroto;Gomi, Fumi
目的评价日本临床视网膜研究组（J-CREST） 1252例日本患者（1406眼）注射曲安奈德（subtenon triamcinolone acetonide， STTA）后眼压（IOP）升高的真实证据。方法对1252例患者进行多中心回顾性研究，其中男性676例（758眼）；2013年4月至2017年7月期间在参与中心接受STTA的平均年龄：63.8±12.9岁。结果眼压升高206眼（14.7%），眼压升高。328眼（23.3%）检出6mmhg。106只眼（7.5%）需要药物治疗，2只眼（0.14%）需要手术治疗。年龄较小、基线IOP较高和类固醇剂量是IOP升高相关的危险因素。与IOP升高相关的危险因素。6 mmHg的患者年龄较小，基线IOP较低，类固醇剂量较低，糖尿病性黄斑水肿（DME）和葡萄膜炎的发生率较高。相比之下，当类固醇剂量固定为20mg时，二甲醚发生率较低是IOP升高的危险因素，这表明STTA对IOP升高具有剂量依赖性，特别是对二甲醚患者。结论：我们从大量接受STTA治疗的日本患者中获得的真实证据显示，STTA后IOP升高的发生率为14.7%，并且与年龄较小、基线IOP较高和类固醇剂量有关。因此，应监测IOP，特别是年龄较小、基线IOP较高、DME和葡萄膜炎发生率较高的患者。
PurposeTo evaluate real-world evidence for intraocular pressure (IOP) elevation after subtenon triamcinolone acetonide injection (STTA) in 1252 Japanese patients (1406 eyes) in the Japan Clinical REtina STudy group (J-CREST).MethodsThis was a multicentre retrospective study of the medical records of 1252 patients (676 men (758 eyes); mean age: 63.8 +/- 12.9 years) who received STTA in participating centres between April 2013 and July 2017.ResultsIOP elevation was observed in 206 eyes (14.7%) and IOP increase. 6 mmHg was found in 328 eyes (23.3%). In total, 106 eyes (7.5%) needed medication and two eyes (0.14%) needed surgical procedures. Younger age, higher baseline IOP, and steroid dose were risk factors associated with IOP elevation. Risk factors associated with IOP increase. 6 mmHg were younger age, lower baseline IOP, steroid dose, and higher incidences of diabetic macular oedema (DME) and uveitis. In contrast, with steroid dose fixed at 20 mg, a lower incidence of DME was a risk factor for increased IOP, suggesting that STTA had dosedependent effects on IOP increase, especially in patients with DME.ConclusionOur real-world evidence from a large sample of Japanese patients who received STTA showed that the incidence of IOP elevation after STTA was 14.7%, and was associated with younger age, higher baseline IOP, and steroid dose. Thus, IOP should be monitored, especially in patients with younger age, higher baseline IOP, and higher incidences of DME and uveitis.