RESEARCH ARTICLE


Intraocular Pressure Following Intravitreal Injection of Triamcinolone Acetonide§



Ejaz A Ansari*, N Ali1
1 Maidstone and Tunbridge Wells NHS Trust, Department of Ophthalmology, Maidstone Hospital, Hermitage Lane, Maidstone, ME16 9QQ, UK


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© Ansari and Ali; Licensee Bentham Open

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/), which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the the Maidstone and Tunbridge Wells NHS Trust, Department of Ophthalmology, Maidstone Hospital, Hermitage Lane, Maidstone, ME16 9QQ, UK; Tel: 01622 226275; E-mail: e.ansari@nhs.net
This work was accepted and presented as a poster presentation at EVER, Vilamoura, Portugal 4-6/10/06; Royal College of Ophthalmologists Annual Congress Meeting, Manchester, UK 24/05/06; and Association for Research and Vision in Ophthalmology, Florida, USA (ARVO) 03/05/06.


Abstract

Background:

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

Methods:

This retrospective consecutive non-comparative case series study included 41 patients (52 eyes) (19 male, 22 female, mean age 64.1 ± 13.44; range 22 – 85 years) with progressive exudative ARMD (n = 10 eyes) or diffuse diabetic macular oedema (42 eyes), who received one or more intravitreal injection(s) of 4 mg triamcinolone acetonide.

Results:

IOP increased significantly (p<0.001) from 16.08 (±3.28) mm Hg (range 12-26 mm Hg) preoperatively to a mean maximum of 26.1 (±11.79) mmHg (range 15-80 mm Hg) postoperatively (p<0.001). An IOP rise to values higher than 21 mm Hg was observed in 28 (53.8%) eyes. Elevation of IOP occurred 7.5 weeks (±7.07) after the injection. All five patients (11.9%) with a family history of glaucoma developed an IOP rise above the mean maximum level. The post-injection rise of IOP was statistically independent of gender (p=0.37), but the presence of diabetes mellitus demonstrated a marked influence on the rate of a postoperative elevation of IOP (p=0.05).

Conclusion:

The IOP response following IVTA was consistent with previous studies. A family history of glaucoma and a history of diabetes mellitus may predispose patients to a greater than average IOP rise following IVTA. Careful IOP assessment for at least 6 months post injection is recommended.