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Comparison of 4mg versus 20mg Intravitreal Triamcinolone Acetonide Injections.
  1. Ajay M Tammewar (ajaytams{at}gmail.com),
  2. Lingyun Cheng (cheng{at}eyecenter.ucsd.edu),
  3. Ozcan R Kayikcioglu (okayikcioglu{at}eyecenter.ucsd.edu),
  4. Iryna A Falkenstein (ifalkenstein{at}eyecenter.ucsd.edu),
  5. Igor Kozak (ikozak{at}eyecenter.ucsd.edu),
  6. Michael H Goldbaum (mgoldbaum{at}ucsd.edu),
  7. William R Freeman (freeman{at}eyecenter.ucsd.edu)
  1. Jacobs Retina Center at UCSD Shiley Eye Center, United States
  2. Jacobs Retina Center at Shiley Eye Center, UCSD, United States
  3. Jacobs Retina Center at Shiley Eye Center, UCSD, United States
  4. Jacobs Retina Center at Shiley Eye Center, UCSD, United States
  5. Jacobs Retina Center at Shiley Eye Center, UCSD, United States
  6. Jacobs Retina Center at Shiley Eye Center, UCSD, United States
  7. Jacobs Retina Center at Shiley Eye Center, UCSD, United States

    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.

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