Evidence map›Paper›PMID 38135349›Full record

ArticleBMJ open ophthalmology2023

Incident glaucoma and ocular hypertension after periocular and intravitreal steroid injections: a claims-based analysis.

Ashley Polski, Katy C Liu, Divakar Gupta, Dilraj S Grewal, Joshua Horns, Barbara M Wirostko, Brian C Stagg

Open access · goldAbstract read
PubMed Publisher
In one paragraph

Article in BMJ open ophthalmology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Ashley PolskiDepartment of Ophthalmology, Moran Eye Center, Salt Lake City, Utah, USA ashley.polski@hsc.utah.edu.ORCID 0000-0001-6301-6892
Katy C LiuDepartment of Ophthalmology, Duke Eye Center, Durham, North Carolina, USA.
Divakar GuptaDepartment of Ophthalmology, Duke Eye Center, Durham, North Carolina, USA.
Dilraj S GrewalDepartment of Ophthalmology, Duke Eye Center, Durham, North Carolina, USA.ORCID 0000-0002-2229-5343
Joshua HornsDepartment of Surgery, University of Utah, Salt Lake City, Utah, USA.
Barbara M WirostkoDepartment of Ophthalmology, Moran Eye Center, Salt Lake City, Utah, USA.
Brian C StaggDepartment of Ophthalmology, Moran Eye Center, Salt Lake City, Utah, USA.ORCID 0000-0003-4023-1885
University of Utah · US

Funding

Improving Glaucoma Care Using a Scalable Decision Support SystemK23EY032577 · NEI · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI Brian Stagg · 2022 to 2026
$1.3M
NEI NIH HHS K23 EY032577
6 · The paper itself

Abstract

BACKGROUND/

aimsThis study aims to determine the incidence and risk of open-angle glaucoma or ocular hypertension (OHT) following ocular steroid injections using healthcare claims data.

methodsWe retrospectively reviewed deidentified insurance claims data from the IBM MarketScan Database to identify 19 156 adult patients with no prior history of glaucoma who received ocular steroid injections between 2011 and 2020. Patient demographics and steroid treatment characteristics were collected. Postinjection glaucoma/OHT development was defined as a new diagnosis of glaucoma/OHT, initiation of glaucoma drops, and/or surgical or laser glaucoma treatment. Cox proportional hazards models were used to determine the risk of glaucoma/OHT development within 5 years after first steroid injection.

resultsOverall, 3932 (20.5%) patients were diagnosed with new glaucoma/OHT, 3345 (17.5%) started glaucoma drops and 435 (2.27%) required a laser or surgical glaucoma procedure within 5 years of first steroid injection. Triamcinolone subconjunctival injections were associated with a lower risk of glaucoma/OHT development than retrobulbar or intravitreal steroid injections (p<0.001, HR 0.68, 95% CI 0.59 to 0.79), whereas the 0.59 mg fluocinolone acetonide intravitreal implant had the highest risk of glaucoma/OHT development (p=0.001, HR 2.01, 95% CI 1.34 to 3.02). The risk of glaucoma/OHT development was also higher for patients receiving multiple steroid injections (p<0.001), with the largest increase in risk occurring after three total steroid injections.

conclusionPatients receiving ocular steroid injections are at risk of developing glaucoma/OHT, even with no prior glaucoma/OHT diagnosis or treatment. Patients should be closely monitored for the development of glaucoma following ocular steroid injections, particularly in the setting of intravitreal and/or repeated steroid administration.

Indexed as

GlaucomaGlaucoma, Open-AngleOcular HypertensionAdultHumansIntraocular PressureIntravitreal InjectionsRetrospective StudiesSteroidsVitreous BodySteroidsEpidemiologyGlaucomaIntraocular pressureOcular Hypertension

Identifiers

PMID38135349
OpenAlexW4390100914

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.