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P.S. Severn, H. Koli, S.G. Fraser, D. Steel, R.W. D. Bell; A Comparative Study of the Effects of Intravitreal Triamcinolone on Intraocular Pressure Between Uveitic and Diabetic Patients . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4285.
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To evaluate intraocular pressure changes, pre–operative risk factors, and requirement for ocular hypotensive treatment after intravitreal triamcinolone injection (IVTA).
A retrospective case note analysis was performed. Pre and post operative data was collated, including, age, family history, indication for IVTA, other ophthalmic diagnoses including pre–existing IOP and glaucoma, ocular operations using IVTA, injection related problems and lens status.
Twenty–five patients with uveitis and 40 with diabetes (12 NIDDM and 28 IDDM) were included. Mean age of the uveitis patients was 50.6 years, and 55.3 years for the diabetics. Ten uveitic patients (40%) developed a significant rise in intraocular pressure requiring treatment, compared to 6 diabetic patients (15%). Two uveitic patients developed intractable advancing glaucoma, requiring filtration surgery, four required oral diamox and the remainder were controlled on topical hypotensives alone. The diabetic patients were all successfully treated with topical hypotensives alone. Duration of medical treatment ranged from 1–18 months (mean 9 months) in the uveitic group and from 2 weeks to six months (mean 5 months) in the diabetic group.
Raised IOP is the most common complication post IVTA. In the majority of cases it can be medically controlled. The IOP rise was found to be disease dependant. Uveitic patients were more likely to suffer from increased intraocular pressure, most likely due to a previously compromised trabecular meshwork. The pressure rise in the uveitic group was more severe, prolonged and more difficult to control, with a greater risk of permanent visual loss due to steroid induced glaucoma.
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