Intraocular Pressure Elevation After Intravitreal Triamcinolone Acetonide Injection
Received 15 July 2004; accepted 15 October 2004.
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.
Department of Ophthalmology, Faculty of Clinical Medicine Mannheim of the University Heidelberg, Heidelberg, Germany
Correspondence to J. Jonas, MD, Universitäts-Augenklinik, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
ABSTRACT