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Age as a risk factor for steroid-induced ocular hypertension in the non-paediatric population
  1. Wungrak Choi,
  2. Hyoung Won Bae,
  3. Eun Young Choi,
  4. Minha Kim,
  5. Eun Woo Kim,
  6. Chan Yun Kim,
  7. Min Kim,
  8. Gong Je Seong
  1. Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
  1. Correspondence to Dr Min Kim, Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul 135-720, Korea; minkim76{at}


Background/aims To evaluate the age-related risk of steroid-induced ocular hypertension by analysing intraocular pressure (IOP) changes after intravitreal dexamethasone (DEX, Ozurdex) implant injection.

Methods A retrospective observational study was conducted among patients (n=455; 570 eyes) who had received DEX injection. IOP was measured prior to injection and after 1 week and 1, 2, 3, 6 and 12 months. Results were divided into seven categories based on patient age: 16–30, 31–40, 41–50, 51–60, 61–70, 71–80 and 81–90 years. The IOP elevation rate was compared among the groups.

Results The IOP elevation rate was 42.9% in patients aged ≤30 years (35.3%, 28.3%, 14.9%, 12.2%, 8.4% and 9.1% in the 31–40, 41–50, 51–60, 61–70, 71–80 and 81–90 groups, respectively). Regardless of how IOP was measured, there was an increasing trend in the incidence of IOP elevation with decreasing age. Furthermore, there was a significant stepwise increase in the OR with decreasing age groups. After the 51–60 group was set as the reference point, the ORs (95% CIs) were 5.048 (1.436 to 17.747), 3.671 (1.101 to 12.238), 2.538 (1.043 to 6.178), 0.947 (0.431 to 2.078), 0.713 (0.312 to 1.626) and 0.646 (0.137 to 3.048) in the ≤30, 31–40, 41–50, 61–70, 71–80 and 81–90 groups, respectively.

Conclusion The rate of adverse elevations in IOP after steroid use was significantly lower in older patients than in younger patients. Therefore, caution is required when prescribing steroids to younger patients (<51 years).

  • glaucoma
  • intraocular pressure
  • epidemiology
  • retina

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  • MK and GJS contributed equally.

  • Contributors WC, HWB, MK, and GJS conceived the design of the study. WC, MK, EYC, EWK, CYK, MK, and GJS collected the data. WC, GJS, and CYK analysed and interpreted the data. WC, MK, GJS, and HWB drafted the article. WC, EWK, GJS, CYK, and MK critically revised the article.

  • Funding This work was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF-2019 R1I1A1A01061721 and NRF-2019 R1G1A1008122). The funding organization had no role in the design or conduct of this research.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon request. Data are available upon reasonable request.