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D.L. MacKenzie, J.L. Olson, M.Y. Kahook, N. Faberowski, N. Mandava; Biometric and Intraocular Pressure Evaluation of Eyes Post Intravitreal Triamcinolone Acetonide and Intravitreal Pegaptanib Injection . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4245.
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While the long term sequelae of intravitreal triamcinolone acetonide (IVTA) injections has been studied, short term intraocular pressure (IOP) fluctuations in the acute phase after injection are not entirely understood. We report the immediate post–injection biometric and IOP response of eyes after IVTA and pegaptanib and expand on the implications for ophthalmic care.
We conducted a prospective nonrandomized consecutive case series study of ten eyes injected with either 0.09 cc of 4mg/cc IVTA or 0.09cc of pegaptanib intravitreal injection for diabetic macular edema, central retinal vein occlusion, or age related macular degeneration. Pre–injection IOP, anterior chamber depth (ACD), and axial length (AL) measurements were recorded and repeat measurements were taken at one, five and twenty minutes post–injection. Pressures were obtained using goldmann applanation tonometry and biometric measurements were taken with the IOLMaster.
We enrolled ten eyes in the study with seven receiving pegaptanib and three receiving IVTA. Pre–injection IOP ranged between 9 and 19mm Hg with a mean of 13.4mm Hg. Pre–injection AL ranged between 22.90mm and 25.24mm with a mean of 23.70mm. Immediate post–injection IOP ranged between 23 and 86mm Hg with a mean of 69mm Hg. At 20 minutes IOP ranged between 14 and 36mm Hg with a mean of 22mm Hg. The change in ACD and AL from pre–injection to 20 minutes post–injection was not statistically significant although there was a trend towards anterior chamber shallowing and an increase in AL.
Biometry of the eye in the acute phase post–injection with intravitreal medications reveals an acute rise in pressure which slowly decreases over twenty minutes. This study illustrates the acute rise in pressure seen after injection and reveals that paracentesis is not routinely indicated.
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