Intraocular pressure elevation after intravitreal triamcinolone acetonide injection

Ophthalmology. 2005 Apr;112(4):593-8. doi: 10.1016/j.ophtha.2004.10.042.

Abstract

Purpose: To report on intraocular pressure (IOP) after intravitreal injections of triamcinolone acetonide.

Design: Meta-analysis of previously reported data and case series studies.

Participants: The study included 272 patients (305 eyes) receiving an intravitreal injection of approximately 20 mg triamcinolone acetonide as treatment for diffuse diabetic macular edema (n = 84 patients), exudative age-related macular degeneration (n = 181 patients), retinal vein occlusions (n = 20 patients), uveitis (n = 9), pseudophakic cystoid macular edema (n = 6), and other reasons (n = 5). Mean follow-up was 10.4+/-6.7 months (median, 7.9 months; range, 3.0-35.7 months).

Intervention: Intravitreal injection of approximately 20 mg triamcinolone acetonide.

Main outcome measure: Intraocular pressure.

Results: Intraocular pressure readings higher than 21 mmHg, 30 mmHg, 35 mmHg, and 40 mmHg, respectively, were measured in 112 (41.2%) patients, 31 (11.4%) patients, 15 (5.5%) patients, and 5 (1.8%) patients, respectively. Triamcinolone-induced IOP elevation was treated by antiglaucoma medication in all but 3 (1.0%) eyes, for which filtering surgery was performed. Mean IOP started to rise 1 week after injection and returned to baseline values approximately 8 to 9 months after injection. Younger age (P = 0.029) was significantly associated with triamcinolone-induced ocular hypertension. Triamcinolone responders and triamcinolone nonresponders did not vary significantly in gender (P = 0.42), refractive error (P = 0.86), diabetes mellitus status (P = 0.74), and reason for treatment.

Conclusions: These findings may be useful for comparing risks and benefits of intravitreal triamcinolone acetonide therapy.

Publication types

  • Meta-Analysis

MeSH terms

  • Aged
  • Antihypertensive Agents / therapeutic use
  • Female
  • Glucocorticoids / adverse effects*
  • Humans
  • Injections
  • Intraocular Pressure / drug effects*
  • Male
  • Ocular Hypertension / chemically induced*
  • Ocular Hypertension / drug therapy
  • Prospective Studies
  • Retinal Diseases / drug therapy
  • Risk Factors
  • Time Factors
  • Triamcinolone Acetonide / adverse effects*
  • Vitreous Body

Substances

  • Antihypertensive Agents
  • Glucocorticoids
  • Triamcinolone Acetonide