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