Outcomes of Eyes Lost to Follow-Up After Treatment with Intraocular and Periocular Steroid Injections

A study aimed to characterize patients lost to follow up (LTFU) after intraocular and periocular steroid injection. The results were presented at the American Society of Retina Specialists 2021 Annual Meeting.

This study comprised 53 eyes in 47 patients treated with intraocular or periocular steroid injections for retinal disease, who were LTFU for at least 180 days immediately after treatment and then returned for care. John W. Hinkle and colleagues reviewed charts to discern the indication for treatment, including uveitis-associated cystoid macular edema (CME), diabetic macular edema (DME), post-surgical CME, and retinal vein occlusion (RVO). They also assessed visual acuity (VA), intraocular pressure (IOP), and central foveal thickness (CFT) at the visit before LTFU (baseline), the first return visit, and three, six, and 12 months after the return, if available.

Indications for intraocular and periocular steroid injection treatment among patients who were LTFU were: uveitis-associated CME (43%), DME (25%), post-surgical CME (25%), and RVO (7.5%). The injection preceding LTFU was periocular triamcinolone in 58% of patients and intravitreal steroid in 42% (dexamethasone implant, 28%; intravitreal triamcinolone, 14%). Mean LTFU duration was 295 days. Compared to mean baseline VA (20/77), the VA did not change significantly after return (20/83, P=0.6) or at month 12 (20/87, P=0.6). IOP was ≥21 mmHg in 15% of eyes at return. Only two patients required new IOP treatment, and no patient required glaucoma surgery. The researchers noted that the DME group experienced the only significant increase in mean IOP from baseline to return and to month 12 (13.8 mmHg versus 17.5 and 20.3 mmHg, respectively; P=0.04 and P=0.02).

“Patients LTFU after intraocular or periocular steroid injections did not experience significant morbidity. Mean VA, IOP, and CFT were not significantly worse immediately after LTFU and 12 months later, though patients with DME did experience more significant increases in IOP,” the researchers concluded.

Source: Hinkle J, et al. Outcomes of Eyes Lost to Follow-Up After Treatment with Intraocular and Periocular Steroid Injections. Published for ASRS 2021; October 8-12, 2021, San Antonio, TX.