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Introduction <p>The aim of this real-life study was to analyze the prevalence and risk factors of ocular hypertension (OHT) after fluocinolone acetonide implant (FAc-I) intravitreal injections in the treatment of macular edema of various etiologies.</p> Methods <p>This retrospective, monocentric study included all consecutive patients with ≥ 1 FAc-I injection. The primary endpoint was the occurrence of OHT, defined as intraocular pressure (IOP) of at least 25&#xa0;mmHg and/or an increase ≥ 10&#xa0;mmHg from baseline.</p> Results <p>A total of 171 eyes of 127 patients were injected with FAc-I for diabetic macular edema (61.4%), post-surgical macular edema (19.9%), uveitis (11.1%), and retinal vein occlusion or radiation maculopathy (7.6%). The prevalence of OHT after FAc-I injections was 24.6% (<i>n</i> = 42) and did not differ among groups according to disease (<i>p</i> = 0.943). In most cases, OHT was successfully treated with topical medication alone (14% of the whole cohort, <i>n</i> = 24, 57% of the hypertonic cases). Selective laser trabeculoplasty (SLT) was used in 12 eyes (7.0%). The rate of incisional IOP-lowering surgery was 3.5% (<i>n</i> = 6). In multivariable analysis, risk factors for OHT included younger age (<i>p</i> = 0.036) and pre-existing OHT or glaucoma (<i>p</i> = 0.034). The positive predictive value for the absence of OHT after DEX-I injections was 80.4%.</p> Conclusions <p>OHT occurred in approximately one in four eyes after FAc-I injection and was commonly and successfully treated with topical treatment alone or SLT in 95% of the hypertonic cases (40/42). Risk factors for OHT after FAc-I included younger age and pre-existing OHT or glaucoma. Uveitis and retinal vein occlusion were not risk factors for OHT. Previous DEX-I injection seems to be a useful predictive test. Therefore, regular IOP monitoring is essential for all patients receiving FAc-I injections, especially those with risk factors for OHT.</p>

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Prevalence and Risk Factors of Ocular Hypertension Following Fluocinolone Acetonide (Iluvien®) Intravitreal Injections: The “SAFAC” Study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月1日

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  • Yasmine Serrar,
  • Lucas Sejournet,
  • Benoît Allignet,
  • Sami Bounetta,
  • Marwa Deiri,
  • Chloé Gullon,
  • Ariane Malclès,
  • Philippe Denis,
  • Thibaud Mathis,
  • Laurent Kodjikian

摘要

Introduction

The aim of this real-life study was to analyze the prevalence and risk factors of ocular hypertension (OHT) after fluocinolone acetonide implant (FAc-I) intravitreal injections in the treatment of macular edema of various etiologies.

Methods

This retrospective, monocentric study included all consecutive patients with ≥ 1 FAc-I injection. The primary endpoint was the occurrence of OHT, defined as intraocular pressure (IOP) of at least 25 mmHg and/or an increase ≥ 10 mmHg from baseline.

Results

A total of 171 eyes of 127 patients were injected with FAc-I for diabetic macular edema (61.4%), post-surgical macular edema (19.9%), uveitis (11.1%), and retinal vein occlusion or radiation maculopathy (7.6%). The prevalence of OHT after FAc-I injections was 24.6% (n = 42) and did not differ among groups according to disease (p = 0.943). In most cases, OHT was successfully treated with topical medication alone (14% of the whole cohort, n = 24, 57% of the hypertonic cases). Selective laser trabeculoplasty (SLT) was used in 12 eyes (7.0%). The rate of incisional IOP-lowering surgery was 3.5% (n = 6). In multivariable analysis, risk factors for OHT included younger age (p = 0.036) and pre-existing OHT or glaucoma (p = 0.034). The positive predictive value for the absence of OHT after DEX-I injections was 80.4%.

Conclusions

OHT occurred in approximately one in four eyes after FAc-I injection and was commonly and successfully treated with topical treatment alone or SLT in 95% of the hypertonic cases (40/42). Risk factors for OHT after FAc-I included younger age and pre-existing OHT or glaucoma. Uveitis and retinal vein occlusion were not risk factors for OHT. Previous DEX-I injection seems to be a useful predictive test. Therefore, regular IOP monitoring is essential for all patients receiving FAc-I injections, especially those with risk factors for OHT.