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M. Kahook, J.L. Olson, N. Mandava; Incidence of Increased Intraocular Pressure After Intravitreal Triamcinolone Acetonide Injection . Invest. Ophthalmol. Vis. Sci. 2005;46(13):135.
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Purpose: To analyze the pretreatment diagnoses, incidence and treatment outcome of intraocular pressure (IOP) elevation following intravitreal triamcinolone injection. Methods: Charts of patients undergoing intravitreal triamcinolone injection in one university based practice were reviewed. Mild increase in pressure was defined as 5–10 points, moderate was 11–15 and severe was over 15. Results: We studied 33 eyes of 26 patients whose mean age was 64.1 years. 58% were male and 42 percent female. The mean baseline IOP for all patients was 14.8 mm. Visual acuity prior to injection ranged from 20/50 to count fingers. 18 eyes of 16 (62%) patients showed an increase of pressure greater than 5 points. 75% were male and 25% were female. These patients had a mean age of 59.1 years and a mean baseline IOP of 14.1. Patients with an increase in IOP post injection required treatment due to AMD in 6% of cases, CME in 6%, Posterior uveitis in 6%, DME in 38% and CRVO in 44%. Of those who showed increased IOP at one month 12 were mild, 3 were moderate and 2 severe. At six months 2 eyes showed mild elevation in IOP, 1 moderate and no severe cases were seen. 16 (89%) eyes required treatment with 11 (61%) remaining on one or more drops for over six months. One patient (5.5%) required a trabeculectomy for pressure control. Conclusions: Increased intraocular pressure is seen in a large percentage of those treated with intravitreal steroids. The pre–treatment diagnosis might have a positive correlation with which patients might develop higher pressures. While most patients who develop a high intra–ocular pressure are successfully treated with topical drops, our case series involved one patient who required a trabeculectomy to control IOP. Our case series also included a disproportionately larger percentage of men in the steroid responder category.
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