PDF(Pubmed)
Abstract：
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
摘要：
■认识到危险因素并了解类固醇诱导的高眼压（SIOH）的潜在机制对于防止强效视力丧失和确保地塞米松（DEX）注射的安全性和有效性至关重要。该研究旨在开发一种新的列线图，用于预测SIOH的风险并确定类固醇注射的安全区。
■这个单中心，回顾性,病例对照研究共纳入154只眼睛,测量的眼轴长度均在延世大学卫生系统进行了AS-OCT和DEX植入.眼睛分为SIOH（n=39）和类固醇后正常IOP（n=115）组。我们在DEX植入前测量了所有眼睛的眼内压（IOP），植入后1周，以及此后的1、2、3、6和12个月。我们使用AS-OCT分析小梁网（TM）高度和眼部参数。
■预测列线图，包括TM高度，得出的AUC为0.807(95%置信区间[CI]，0.737-0.877)，并显示出比以前的列线图显著更高的预测准确性，不考虑TM身高，AUC为0.644（95%CI，0.543-0.745）（p=0.031）。对于约0.4的预测值,校准图显示出强的预测准确性。我们建立了临界值，以确保DEX植入后安全区内不同水平的敏感性和特异性。
■我们改进的列线图将TM高度作为新确定的风险因素，建立了玻璃体内DEX植入的安全阈值，帮助从需要谨慎的人中识别安全的人。
■这个单中心，回顾性,病例对照研究共纳入154只眼睛,测量的眼轴长度均在延世大学卫生系统进行了AS-OCT和DEX植入.眼睛分为SIOH（n=39）和类固醇后正常IOP（n=115）组。我们在DEX植入前测量了所有眼睛的眼内压（IOP），植入后1周，以及此后的1、2、3、6和12个月。我们使用AS-OCT分析小梁网（TM）高度和眼部参数。
■预测列线图，包括TM高度，得出的AUC为0.807(95%置信区间[CI]，0.737-0.877)，并显示出比以前的列线图显著更高的预测准确性，不考虑TM身高，AUC为0.644（95%CI，0.543-0.745）（p=0.031）。对于约0.4的预测值,校准图显示出强的预测准确性。我们建立了临界值，以确保DEX植入后安全区内不同水平的敏感性和特异性。
■我们改进的列线图将TM高度作为新确定的风险因素，建立了玻璃体内DEX植入的安全阈值，帮助从需要谨慎的人中识别安全的人。
