Abstract
Purpose: :
To compare the incidence of steroid response and ocular hypertension (OHTN) after sub-Tenon's injection (STK) versus intravitreal injection (IVK) of Triamcinolone in the treatment of macular edema and to correlate the incidence of OHTN with the demographic data.
Methods: :
Retrospective chart review of 100 consecutive patients that received STK (36 eyes) and IVK (92 eyes) from January of 2004 to November of 2008. Demographic data included sex, age, ethnicity. Steroid response in this study was defined as a rise of at least 30% in the intraocular pressure (IOP) compared to the baseline in any of the follow up visits; OHTN in this study was defined as an IOP reading > 21 mmHg at the end of the follow up period. Short term follow up occurred at 1 week and 1, 2, and 3 months. A minimum of 3 IOP readings were required for inclusion in this study. Statistical analysis was performed using a chi-squared test, Wilcoxon rank sum test, and Spearman rank correlation.
Results: :
7 (19.4%) of 36 eyes in the STK group developed a steroid response compared with 27 (29.3%) of 92 eyes in the IVK group. OHTN was observed in 6 of 36 eyes (16.7%) of the STK group compared with 7 of 92 eyes (7.5%) of the IVK group, but the difference was not statistically significant (p=0.36, chi-square test). All but one patient had their IOP controlled with topical anti-glaucoma therapy. The one patient that necessitated surgery to control the IOP underwent a seton implant surgery. There was no significant difference on IOP change between blacks and non-blacks (p=0.35), between males and females (p=0.14) of the OHTN population. The p-value (0.56>0.05) for the Spearman rank correlation coefficient (-0.063) between age and IOP change indicated that age was not associated with IOP change.
Conclusions: :
In this small retrospective chart review, steroid response occurred more frequently in IVK treated eyes but OHTN response was more frequent in STK treated eyes. OHTN was not associated with older age, sex or race.
Keywords: intraocular pressure • edema