类固醇诱导的高眼压的频率依赖性风险
Frequency-dependent risk of steroid-induced ocular hypertension.
摘要(中文译文)
目的：评估重复玻璃体内注射地塞米松（DEX）植入物后类固醇性高眼压（SIOH）的发生率及危险因素，特别关注迟发性SIOH，即首次注射时未出现而在后续注射后发生。方法：本回顾性研究纳入2005年至2024年间接受DEX植入物治疗的1，105只眼。在基线、每次注射后1周及1、2、3、6和12个月测量眼压（IOP）。采用多变量logistic回归评估潜在预测因素，包括注射次数，并使用Cox比例风险模型分析SIOH的累积发生率。比较单次注射SIOH与多次注射SIOH之间多次注射SIOH危险因素及IOP轨迹的亚组分析。结果：与仅接受一次DEX植入物注射的眼相比，接受两次、三次、四次和五次注射的SIOH比值比（OR）分别为：2.190（p = 0.004）、2.558（p = 0.012）、2.560（p = 0.049）和4.306（p = 0.005）。在多次注射后发生SIOH的眼中，较长的眼轴长度是显著的解剖学预测因素（OR = 1.630，p = 0.013）。IOP趋势有所不同：多次注射SIOH病例表现为较缓慢但更持续的眼压升高。结论：重复玻璃体内注射DEX植入物显著增加SIOH风险。即使首次注射时未发生SIOH的眼，在后续注射后仍可能出现迟发性SIOH。长眼轴可能促进多次注射后SIOH的发生，表现为迟发且持续的眼压升高，强调持续监测的重要性。
Abstract
PURPOSE: To evaluate the incidence and risk factors of steroid-induced ocular hypertension (SIOH) following repeated intravitreal dexamethasone (DEX) implant injections, with particular focus on delayed SIOH, defined as its absence at the first injection and occurrence following subsequent injections. METHODS: This retrospective study included 1,105 eyes treated with DEX implants between 2005 and 2024. Intraocular pressure (IOP) was measured at baseline, 1 week, and 1, 2, 3, 6, and 12 months after each injection. Multivariable logistic regression assessed potential predictors including injection number, and cumulative incidence of SIOH was analyzed using Cox proportional hazards models. Subgroup analyses of multiple-injection SIOH risk factors and IOP trajectories were compared between single-injection and multiple-injection SIOH. RESULTS: Compared to eyes that received only one DEX implant injection, the odds ratios (ORs) for SIOH were: 2.190 (p = 0.004), 2.558 (p = 0.012), 2.560 (p = 0.049), and 4.306 (p = 0.005) for two, three, four, and five injections, respectively. In eyes that experienced SIOH after multiple injections, longer axial length was a significant anatomical predictor (OR = 1.630, p = 0.013). IOP trends differed: multiple-injection SIOH cases showed slower but more sustained elevations. CONCLUSION: Repeated intravitreal DEX implant injections significantly increased the risk of SIOH. Delayed SIOH may occur after subsequent injections even in eyes without SIOH at first injection. Long axial length may contribute to SIOH after multiple injections, with delayed and sustained IOP elevation, underscoring the importance of continued monitoring.
如何引用
AMA
Injeong Cho, Heesuk Kim, Jin-Ok Choi, Chan Yun Kim, Wungrak Choi. Frequency-dependent risk of steroid-induced ocular hypertension.. Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie. 2026; doi:10.1007/s00417-026-07242-z.
APA
Injeong Cho, Heesuk Kim, Jin-Ok Choi, Chan Yun Kim, Wungrak Choi (2026). Frequency-dependent risk of steroid-induced ocular hypertension.. Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie. https://doi.org/10.1007/s00417-026-07242-z
GB/T 7714
Injeong Cho, Heesuk Kim, Jin-Ok Choi, Chan Yun Kim, Wungrak Choi. Frequency-dependent risk of steroid-induced ocular hypertension.[J]. Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2026 doi:10.1007/s00417-026-07242-z.
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