Intraocular pressure following intravitreal injection of triamcinolone acetonide

الملخص EN

Background : To investigate the intraocular pressure (IOP) response following intravitreal injection of triamcinolone acetonide (IVTA).

Design : Retrospective.

Setting : Department of Ophthalmology, Maidstone Hospital.

Method : Retrospective non-comparative case study which included 41 patients (52 eyes) (19 male, 22 female, mean age 64.1 ± 13.44 ; range 22-85 years) with progressive exudative age-related macular degeneration ARMD (n = 10 eyes) or diffuse diabetic macular oedema (42 eyes).

The patients received one or more intravitreal injection(s) of 4 mg triamcinolone acetonide.

Result : IOP increased significantly (p < 0.001) from 16.08 (± 3.28) mmHg (range 12-26 mmHg) preoperatively to a mean maximum of 26.1 (± 11.79) mmHg (range 15-80 mmHg) postoperatively (p < 0.001).

An IOP rise to values higher than 21 mmHg was observed in 28 (53.8 %) eyes.

Elevation of IOP occurred 7.5 weeks (± 7.07) after the injection.

In all but one eye, IOP could be lowered to the normal range with topical medication without development of glaucomatous optic nerve head changes.

In the eye with an elevation of IOP to 80 mmHg, an anterior chamber tap was performed resulting in an effective reduction in pressure to 21 and then to a final IOP of 12.

All five patients (11.9 %) with a family history of glaucoma developed an IOP rise above the mean maximum level.

Conclusion : After intravitreal injections of 4 mg of triamcinolone acetonide, an IOP elevation greater than 21 mmHg developed in 53.8 % of eyes, starting on average 7.5 weeks after the injection.

In 98.1%, IOP was normalised by topical medication alone 6 months after the injection.

A family history of glaucoma may predispose patients to a greater than average IOP rise following IVTA.