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P. Atmaca–Sonmez, K. Sonmez, C.C. Barr, T.H. Tezel, H.J. Kaplan; Ocular Hypertension is More Common in Diabetic Macular Edema and Uveitis Than AMD Following Intravitreal Triamcinolone Acetonide Injection . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3941.
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Purpose: To evaluate the complications and associated risk factors after intravitreal triamcinolone acetonide (IVTA) injection. Methods: The charts of patients who had an IVTA injection and were regularly followed for a minimum of 3 months were reviewed. An association was sought between increased intraocular pressure (IOP) and age, sex, race, lens status (phakia vs pseudophakia), posterior capsule status (intact vs open), anterior chamber tap post–IVTA, prior treatment (trabeculectomy, vitrectomy), the type of diabetic retinopathy, glaucoma or ocular hypertension, and other possible risk factors. The characteristics of the IOP increase and the response of eyes to IVTA in bilaterally injected patients were also noted. Results: Fifty–one eyes of 49 patients with CNV secondary to AMD, 49 eyes of 40 patients with DME and 13 eyes of 12 patients with uveitis who had an IVTA injection were included in the study. 83% of eyes were followed–up for at least 6 months. Of the 113 eyes, 51 (45.1%) had an IOP greater than 21mmHg and 29 (25.7%) had greater than 25mmHg during the follow–up period. Young patients were more likely to experience an IOP increase (p=0.0001). An IOP increase occurred early in eyes with uveitis (mean 19.4 days), and late in eyes with DME (88.3 days). Eyes with AMD were the least likely to experience an increase in IOP (29.4%), compared to DME (59.2%) and uveitis (53.9%)(p=0.05). An open posterior capsule seemed to have a protective effect since 2 out of 13 eyes (15.4%) with an open posterior capsule and 20 pseudophakic eyes (47.6%) with an intact posterior capsule experienced an IOP increase (p=0.05). Sixteeen (14.2%) eyes developed a posterior subcapsular cataract; 1 eye, mild iritis; 1 aphakic eye, had TA enter the anterior chamber; 2 eyes, branch vein occlusion. Conclusions: Although IOP elevation after IVTA injection is common, it can usually be controlled medically. The IOP increase varied depending on the underlying disease and was worse for DME and uveitis compared to AMD. Young patients and eyes with an intact posterior capsule were under increased risk for developing IOP elevation.
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