Comparison of 4mg versus 20mg Intravitreal Triamcinolone Acetonide Injections

¹ Jacobs Retina Center at UCSD Shiley Eye Center, United States
² Jacobs Retina Center at Shiley Eye Center, UCSD, United States

^* To whom correspondence should be addressed. E-mail: cheng{at}eyecenter.ucsd.edu.

Accepted 5 March 2008

	Abstract

Aims: To compare the non-decanted (standard) 4mg versus the decanted 20 mg intravitreal triamcinolone acetonide (IVTA) injections and to assess their effect on intraocular pressure (IOP).

Methods: We retrospectively reviewed the records of 92 consecutive eyes, which received an intravitreal injection of either dose of TA, at a single retina center. The change in IOP (elevation of at least 5 mmHg from baseline or above 21 mmHg) was analyzed with a multivariate logistic analysis. The mean follow up period in both groups was 27 weeks. Subgroup analysis comparing vitrectomized to non-vitrectomized eyes in both groups was also performed.

Results: Of the 92 eyes, 46% (23 of 51) in the 4 mg group versus 30 % (12 of 41) in the 20 mg group had an IOP > 21 mm of Hg (p=0.14) after mean follow-up period of 27 weeks. The vitrectomized eyes (3 of 24) in the 20 mg group had a significantly lower rate of IVTA induced IOP elevation than the non-vitrectomized eyes (9 of 17) (p=0.013). The IOP elevation occurred significantly earlier in the 4mg group (vitrectomized eyes 27±43 days and non-vitrectomized eyes 61±52 days) than in the 20 mg group (vitrectomized eyes 104±56 days and non-vitrectomized eyes 119±82 days), independent of the vitreous status (vitrectomized p= 0.05 and non-vitrectomized p=0.04). The mean value of initial high IOP in the non-vitrectomized eyes was higher in 4 mg group than the corresponding 20 mg group (p=0.048).

Conclusion: Decanted 20 mg IVTA may not pose a significantly greater risk of IOP elevation than the 4 mg non-decanted IVTA.