Cataract Progression After Intravitreal Triamcinolone Injection
This study was partly presented at the Association for Research in Vision and Ophthalmology Annual Meeting, Fort Lauderdale, Florida, April 2004; and at the American Academy of Ophthalmology Annual Meeting, New Orleans, Louisiana, October, 2004.
Accepted 15 January 2005. published online 05 May 2005.
Purpose
To assess cataract progression after intravitreal triamcinolone injection.
Forty-two phakic eyes of 37 patients were injected one, two, or three times with intravitreal triamcinolone for various indications. Noninjected phakic fellow eyes served as the control. The mean follow-up time for single injection was 12 months, for multiple injections was 14 months, and for control group was 13 months. Lens status, best-corrected visual acuity, and refractive errors were recorded at baseline and at each follow-up examination.
Results
At the last follow-up, changes in posterior subcapsular cataract and refractive error from baseline were significantly different between single triamcinolone-injected eyes and the control group [0.7 ± 0.2 (mean ± SEM [arbitrary unit] vs 0.2 ± 0.1, P = .02; and −0.5 ± 0.1 diopter vs −0.2 ± 0.1 diopter, P = .01, respectively). For multiple-injected eyes and control eyes, change from baseline in corticonuclear cataract (1.1 ± 0.2 vs 0.2 ± 0.1), posterior subcapsular cataract (1.1 ± 0.2) and refractive error (−1.8 ± 0.4 diopters) were significantly different (P < .001, P < .001, and P < .001, respectively). Visual acuity did not change after single injection (P = .83) and in control group (P = .19) but decreased after multiple injections (P = .006). Eleven study eyes and two control group eyes underwent cataract extraction during study period. Corticonuclear and posterior subcapsular cataract progression significantly correlated with follow-up time (P = .003 and P = .02, respectively) and number of injections (P = .01 and P = .04, respectively).
Conclusions
Single intravitreal triamcinolone injection induces posterior subcapsular cataract development, whereas multiple injections result in all-layer cataract progression.
Department of Ophthalmology, College of Surgeons and Physicians of Columbia University, Harkness Eye Institute, New York, New York
Inquiries to Osman Çekiç, MD, PhD, Department of Ophthalmology, College of Surgeons and Physicians of Columbia University, Harkness Eye Institute, 635 West 165th Street, New York, NY 10032; fax: 212-305-5962
ABSTRACT