Abstract:
These guidelines are a consensus of French glaucoma and retina experts on the management of ocular hypertension (OHT) observed in a third of the cases after corticosteroid implant intravitreal injections. They update the first guidelines published in 2017. Two implants are marketed in France: the dexamethasone implant (DEXi) and the fluocinolone acetonide implant (FAci). It is essential to assess the pressure status before injecting a patient with a corticosteroid implant. A molecule-specific monitoring of the intraocular pressure is needed throughout the follow-up and at the time of reinjections. Real-life studies have allowed optimizing the management algorithm by significantly increasing the safety of these implants. Corticosteroid testing with DEXi should be performed before switching to FAci to optimize pressure tolerance of FAci. Beyond topical hypotensive treatments, selective laser trabeculoplasty may be considered in the therapeutic arsenal for the management of steroid-induced OHT and subsequent injections.
摘要:
这些指南是法国青光眼和视网膜专家对皮质类固醇植入物玻璃体内注射后三分之一病例中观察到的高眼压(OHT)管理的共识。他们更新了2017年发布的第一份指南。在法国销售两种植入物:地塞米松植入物(DEXi)和氟轻松缩内酯植入物(FAci)。在向患者注射皮质类固醇植入物之前,必须评估压力状态。在整个随访过程中和再次注射时,需要对眼内压进行分子特异性监测。现实生活中的研究已经允许通过显著提高这些植入物的安全性来优化管理算法。在切换到FAci之前,应使用DEXi进行皮质类固醇测试,以优化FAci的耐压性。除了局部降压治疗,选择性激光小梁成形术可考虑用于治疗类固醇诱导的OHT和随后的注射.