May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Intravitreal Triamcinolone Injection and Frequency, Characteristics, and Risk Factors in the Development of Secondary Intraocular Pressure Elevation
Author Affiliations & Notes
  • S. M. Walsman
    UMDNJ - New Jersey Med Sch, Newark, New Jersey
    Ophthalmology,
  • J. Hade
    UMDNJ - New Jersey Med Sch, Newark, New Jersey
    Ophthalmology,
  • M. Brimacombe
    UMDNJ - New Jersey Med Sch, Newark, New Jersey
    Biostatistics,
  • Retina Associates of New Jersey
    UMDNJ - New Jersey Med Sch, Newark, New Jersey
  • P. Lama
    UMDNJ - New Jersey Med Sch, Newark, New Jersey
    Ophthalmology,
  • Footnotes
    Commercial Relationships  S.M. Walsman, None; J. Hade, None; M. Brimacombe, None; P. Lama, None.
  • Footnotes
    Support  Unrestricted Grant from Research to Prevent Blindness, Inc, NY; Lions Eye Research Foundation of New Jersey.
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 2096. doi:https://doi.org/
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      S. M. Walsman, J. Hade, M. Brimacombe, Retina Associates of New Jersey, P. Lama; Intravitreal Triamcinolone Injection and Frequency, Characteristics, and Risk Factors in the Development of Secondary Intraocular Pressure Elevation. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2096. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To assess the frequency and characteristics of an intravitreal triamcinolone (IVT) related IOP elevation and to identify pre-treatment risk factors that may be associated with more severe and refractory IOP control.

Methods: : Retrospective chart review of all patients receiving an IVT injection at tertiary care retinal practice between November 1997 and September 2004 was conducted.

Results: : IVT injections were associated with a clinically significant rise in IOP in 69.9%(n=366) of patients with a mean change in IOP of 8.67 mmHg and a mean IOPmax of 24.85mmHg. Elevation in IOP was observed to occur at any time post IVT injection but the average time to IOPmax was 1-2 months with the time to IOPmax curve following a Gaussian distribution. Younger age, concurrent treatment for glaucoma, and higher baseline IOP were associated with a significantly increase risk of a severe or medical refractory IOP elevation. Gender, race/ethnicity, pre-treatment retinal diagnosis, past medical history of diabetes, hypertension, or atherosclerotic vascular disease were not associated with an increased risk of an IVT-related IOP elevation.

Conclusions: : Clinically significant IVT-related IOP elevation occurred at a greater frequency than all previously published studies. Most patients can be treated successfully with initiation of or escalation of glaucoma therapy. In the absence of well-designed randomized clinical studies demonstrating long-term clinical benefit from IVT injections as compared to conventional treatment we caution clinicians to carefully assess the risk/benefit ratio of IVT

Keywords: intraocular pressure • injection • corticosteroids 
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