Dexamethasone concentration in the subretinal fluid after a subconjunctival injection, a peribulbar injection, or an oral dose

Olga Weijtens, Rik C. Schoemaker, Eef G.W.M. Lentjes, Fred P.H.T.M. Romijn, Adam F. Cohen, Jan C. Van Meurs*

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    68 Citations (Scopus)

    Abstract

    Purpose: To determine dexamethasone concentrations in the subretinal fluid of patients after a peribulbar injection, a subconjunctival injection, or an oral dose of dexamethasone and to compare the results with those of previous similar studies of dexamethasone concentrations in the vitreous. Design: Prospective, nonrandomized, comparative trial. Participants: One hundred forty-eight patients with a rhegmatogenous retinal detachment. Methods: Fifty patients received a peribulbar injection of 5 mg dexamethasone disodium phosphate, 49 received a subconjunctival injection of 2.5 mg dexamethasone disodium phosphate, and 49 received an oral dose of 7.5 mg dexamethasone at various time intervals before surgery. At the time of surgery, a subretinal fluid sample was taken from each patient. Main Outcome Measures: The dexamethasone concentration in the subretinal fluid measured by radioimmunoassay. Results: The estimated maximum dexamethasone concentrations in the subretinal fluid after the peribulbar injection, the subconjunctival injection, and the oral dose were, respectively, 82.2 ng/ml (standard error, 17.6), 359 ng/ml (standard error, 80.2), and 12.3 ng/ml (standard error, 1.61). Corrected for dose, the maximum dexamethasone concentrations after subconjunctival injection and peribulbar injection were, respectively, 120 (95% confidence interval, 54/180) and 13 (95% confidence interval, 6.8/20) times greater than after oral administration. Conclusions: A subconjunctival injection of dexamethasone disodium phosphate is more effective in delivering dexamethasone into the subretinal fluid of patients with a rhegmatogenous retinal detachment compared with peribulbar injection or oral administration. The subretinal dexamethasone concentrations were higher than concentrations measured in the vitreous in previous studies with a similar setup after all three delivery methods. (C) 2000 American Academy of Ophthalmology.

    Original languageEnglish
    Pages (from-to)1932-1938
    Number of pages7
    JournalOphthalmology
    Volume107
    Issue number10
    DOIs
    Publication statusPublished - 24 Oct 2000

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