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O. Cekic, S. Chang, J. Tseng, Y. Akar, G. Barile, W. Schiff; Cataract Progression After Intravitreal Triamcinolone Injection . Invest. Ophthalmol. Vis. Sci. 2004;45(13):5228.
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Purpose: To assess cataract progression after intravitreal triamcinolone injection. Methods: Thirty–one phakic eyes of 25 patients (mean age 62 years) were injected one (n=19), two (n=5), or three times (n=7) with intravitreal triamcinolone for cystoid macular edema due to diabetic retinopathy or retinal vein occlusion. Overall mean follow–up time was 9 months (range 3–20 months). Mean follow up time for single injection was 5 months (range 3–15 months), for 2 injections was 11 months (range 8–14 months) and for 3 injections was 15 months (range 13–20 months). Non–injected phakic eyes served as the control group (n=14); the mean follow–up time was 8 months. Lens status, best corrected visual acuity, and refractive errors were recorded. Lens status was assessed by slit lamp biomicroscopy throughout the follow up period and was graded by corticonuclear opacity (grade scale 0–3) and subcapsular opacity (grade scale 0–3). Results:In the control eyes, there was no difference between baseline and follow up values for the following parameters: lens score: 0.8 ± 0.2 (mean ± SEM) versus 1.1 ± 0.3 (P = 0.27); best corrected visual acuity (decimal notation): 0.3 ± 0.6 versus 0.3 ± 0.6 (P = 0.13); and refractive error: –0.2 ± 0.8 diopters versus –0.5 ± 0.8 diopters (P = 0.1). In study eyes, lens score increased significantly from 0.9 ± 0.1 to 2.0 ± 0.3 (P < 0.01); best corrected visual acuity decreased from 0.08 ± 0.4 to 0.05 ± 0.3 (P = 0.02) and refractive error shifted from –0.6 ± 0.7 diopters to –1.6 ± 0.6 diopters (P = 0.04) after triamcinolone injection. Overall, cataract progression was seen in 18 of 31 triamcinolone injected eyes (58%). Eight of 31 eyes (26%) underwent cataract extraction in average 14 months after the first injection and with a mean lens score of 3.0 ± 0.3. Seven of those 8 eyes had multiple injections. All patients with more than 8 months of follow up (n=16), regardless of number of injections, showed cataract progression. Cataract progression significantly correlated with follow up time (P < 0.001) and number of injections (P < 0.001). Conclusions:Intravitreal triamcinolone induces cataract progression. The number of injections and the duration of follow up time correlate with the degree of cataract formation.
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