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Elizabeth Anne Atchison, Sophie J Bakri; Intraocular pressure response to intravitreal Triesence injection. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2671.
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© ARVO (1962-2015); The Authors (2016-present)
Elevated intraocular pressure (IOP) is the most frequent adverse event associated with intravitreal triamcinolone acetate (IVTA) injection. The incidence of this has been examined in older, preserved forms of IVTA but to our knowledge the effect of newer, preservative free formulations has not been clinically evaluated. This study is a retrospective, observational clinical study aiming to examine the frequency of IOP related adverse events after intravitreal Triesence injection.
Patients (pts) who received intravitreal Triesence between March 2008 and April 2014 were included in our IRB-approved study. Patients without at least 1 IOP recorded after injection were excluded. For each patient age, sex and history of ocular hypertension or glaucoma were recorded. For each injection, the pre-injection IOP, maximum IOP (IOP max) within 6 months or until the next injection, dose of injection and indication for injection were collected. Pressure rise was calculated as IOP max minus preinjection pressure. Comparison of means was by Student’s T test.
14 pts received 72 injections of Triesence in 19 eyes. All injections were done for CME with etiologies of: uveitis (1 pt), branch retinal vein occlusion (1 pt), central retinal vein occlusion (4 pt), and diabetes mellitus (8 pt). 7 pts had a history of glaucoma or OHT. For all pts the mean preinjection IOP was 15.4 mmHg and the mean IOP max was 19.8 mmHg. The mean IOP max occurred 63 days after injection. For the 2 mg dose the average IOP max was 20.7 mmHg. For the 4 mg dose the average IOP max was 19.0 mmHg. This difference was not statistically significant (p=0.26). Table 1 shows the frequency of IOP max and IOP rise of different magnitudes. 1/14 pts required surgery to control IOP. 2/14 pts required medical therapy to control IOP. Specifically, one pt had a long history of glaucoma on maximum medical therapy and needed a tube shunt 5 months after injection. Another had no glaucoma history and required brimonidine and then dorzolamide/timolol to control IOP while receiving IVTA. Another with a history of OHT required therapy with dorzolamide/timolol 1 month after injection.
The IOP related adverse events with Triesence are similar in frequency and severity to older, preserved forms for IVTA. In our small study this effect was not dose dependent.
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