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Bob Hampton, Diabetic Retinopathy Clinical Research Network; Frequency Of Intraocular Pressure Increase Within Days After Intravitreal Triamcinolone Injections In The Diabetic Retinopathy Clinical Research Network. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1512.
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To assess the frequency of measured intraocular pressure (IOP) rise within a few days following an intravitreal injection in study participants receiving triamcinolone in a randomized trial in the Diabetic Retinopathy Clinical Research Network (DRCR.net).
In 505 eyes following 1510 injections, IOP was measured at 4+3 days (referred to as the "4-day visit") after each injection of 1mg or 4mg triamcinolone acetonide (TRIVARIS; Allergan, Inc., Irvine, CA). From the IOP measurements at this visit, we determined the frequency of an ‘IOP event’ defined as an increase from the pre-injection IOP of more than 10 mmHg to IOP ≥30 mmHg.
Two eyes (0.8%) in the 1mg group and 1 eye (0.4%) in the 4mg group had an ‘IOP event’ following baseline injection (1 to 7 days). Of the 3 eyes (0.6%) with IOP events following the baseline injection, all were treated with IOP lowering medication after the event and had an IOP <30 mmHg at the last available study visit. Twelve eyes (3%), including 4 in the 1-mg group and 8 in the 4-mg group, had IOP events following multiple injections. Eleven of these were treated with IOP lowering medication and all but one, specifically in the 4 mg group, were controlled with IOPs under 30 mmHg by the last available study visit.
Substantial IOP increase at the 4-day post injection visit in a few study participants undergoing intravitreal triamcinolone acetonide injection was unexpected and, to our knowledge, previously unreported. The reasons for elevated IOP in this time frame are unclear. The low risk of this IOP increase and the lack of evidence of long term clinical harm from delay in diagnosis do not seem sufficient to justify routine assessment of patients within 1 to 7 days of injection in patients with our study characteristics.
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