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Clinical prediction nomogram for steroid-induced ocular hypertension risk in patients with intravitreal dexamethasone implant

Authors
 Won Jeong Cho  ;  Hye Jung Shin  ;  Min Kim  ;  Hyoung Won Bae  ;  Chan Yun Kim  ;  Wungrak Choi 
Citation
 HELIYON, Vol.10(14) : e34635, 2024-07 
Journal Title
HELIYON
Issue Date
2024-07
Keywords
Anterior segment optical coherence tomography ; Intraocular pressure ; Intravitreal dexamethasone injection ; Steroid-induced ocular hypertension ; Trabecular meshwork height
Abstract
Background: Recognizing the risk factors and understanding the mechanisms underlying steroid- induced ocular hypertension (SIOH) are vital to prevent potent vision loss and ensure the safety and effectiveness of dexamethasone (DEX) injections. The study aimed to develop a novel nomogram for predicting the risk of SIOH and determining safety zones for steroid injections. Methods: This single-center, retrospective, case-control study included a total of 154 eyes with available measured axial length that had undergone AS-OCT and DEX implantation at the Yonsei University Health System. The eyes were categorized into the SIOH (n = 39) and post-steroid normal IOP (n = 115) groups. We measured intraocular pressure (IOP) for all eyes prior to DEX implantation, at 1 week post-implantation, and at 1, 2, 3, 6, and 12 months thereafter. We used AS-OCT to analyze the trabecular meshwork (TM) height and ocular parameters. Results: The predictive nomogram, including TM height, yielded an AUC of 0.807 (95 % confidence interval [CI], 0.737-0.877) and demonstrated significantly higher predictive accuracy than that of previous nomograms, which did not consider TM height and had an AUC of 0.644 (95 % CI, 0.543-0.745) (p = 0.031). The calibration plot demonstrated a strong predictive accuracy for a predicted value of approximately 0.4. We established cutoff values to ensure different levels of sensitivity and specificity within the safety zone following DEX implantation. Conclusion: Our improved nomogram incorporating TM height as a newly identified risk factor, established a safety threshold for intravitreal DEX implantation, helping identify safe individuals from those who require caution.
Files in This Item:
T202404878.pdf Download
DOI
39130483
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min(김민) ORCID logo https://orcid.org/0000-0003-1873-6959
Kim, Chan Yun(김찬윤) ORCID logo https://orcid.org/0000-0002-8373-9999
Bae, Hyoung Won(배형원) ORCID logo https://orcid.org/0000-0002-8421-5636
Choi, Wungrak(최웅락) ORCID logo https://orcid.org/0000-0002-3015-2502
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/200377
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