May 2007
Volume 48, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2007
A Pharmacogenomic Pilot Study on Steroid-Induced Intraocular Pressure Elevation Following Intravitreal Triamcinolone Acetonide (IVTA) Injection
Author Affiliations & Notes
  • S. M. Gerzenstein
    Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • S. G. Schwartz
    Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • C. A. Puliafito
    Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • A. C. L. Cervino
    The Scripps Research Institute, Jupiter, Florida
  • N. F. Tsinoremas
    The Scripps Research Institute, Jupiter, Florida
  • M. E. Fini
    Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • Miami Ocular Pharmacogenomics Team
    Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • Footnotes
    Commercial Relationships S.M. Gerzenstein, None; S.G. Schwartz, Genentech, F; Pfizer, I; Novartis, R; C.A. Puliafito, Carl Zeiss Meditec, P; Eyetech, Genentech, Pfizer, Carl Zeiss Meditec, R; A.C.L. Cervino, None; N.F. Tsinoremas, None; M.E. Fini, None.
  • Footnotes
    Support Prevent Blindness America Investigator Award, NIH center grant P30-EY014801, and an unrestricted grant to the University of Miami from Research to Prevent Blindness
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 266. doi:
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      S. M. Gerzenstein, S. G. Schwartz, C. A. Puliafito, A. C. L. Cervino, N. F. Tsinoremas, M. E. Fini, Miami Ocular Pharmacogenomics Team; A Pharmacogenomic Pilot Study on Steroid-Induced Intraocular Pressure Elevation Following Intravitreal Triamcinolone Acetonide (IVTA) Injection. Invest. Ophthalmol. Vis. Sci. 2007;48(13):266.

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

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Abstract

Purpose:: Off-label injection of intravitreal triamcinolone acetonide (IVTA) is a common treatment for various macular diseases. A major complication of IVTA is increased intraocular pressure (IOP) and steroid-induced glaucoma. Presently, it is not possible to predict which patients will develop complications, although some reports have suggested that genetic factors may be predisposing. In this study, we sought a pharmacogenomic relationship between IVTA-induced IOP elevation and polymorphisms in the glucocorticoid receptor gene.

Methods:: Fifty-two patients treated with IVTA met all entry criteria for this study. The major clinical data points were baseline IOP and maximum IOP recorded during the 3 months following injection. DNA analysis was performed for 6 well known polymorphisms of the glucocorticoid receptor gene (GluArg22/23GluLys, Asn363Ser, IVS2+646C>G, IVS3-4G>C, IVS4-16G>T, and Asn766Asn).

Results:: The polymorphisms GluArg22/23GluLys, Asn363Ser, and IVS3-4G>C showed little variation within this sample and were excluded from more detailed analysis. The polymorphisms IVS2+646C>G, IVS4-16G>T, and Asn766Asn met Hardy-Weinberg equilibrium. No polymorphism was individually associated with IOP response via regression analysis. Six different haplotypes studied via regression analysis were not associated with IOP response.

Conclusions:: In this small pilot study, we did not find a pharmacogenomic relationship between genetic polymorphisms in the glucocorticoid receptor and IVTA-induced IOP elevation. At this time, we are continuing to recruit patients in order to do a complete steroid pathway candidate gene analysis, and ultimately a whole genome screen.

Keywords: corticosteroids • age-related macular degeneration • gene screening 
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