Complications Associated With Intravitreal Triamcinolone Acetonide Injection – A Study of 1000 Eyes

Abstract

Abstract: : Purpose: To describe the incidence of complications related to the use of intravitreal triamcinolone acetonide (IVT) for the treatment of macular disease. Methods: A retrospective review of 1000 eyes treated with IVT was conducted. Indications for treatment included diabetic macular edema, retinal vein occlusion associated with macular edema, postoperative cystoid macular edema (CME), uveitis associated CME, CME associated with macular pucker, and choroidal neovascularization associated with age–related macular degeneration. Results: One thousand eyes for a total of 1594 injections were treated with 2 or 4 mg of IVT over a 36–month period. Mean follow–up was 8.5 months or 255 days. Ocular hypertension of >21 mm Hg was noted in 38.4% of eyes and a pressure >28 mm Hg was measured in 13.5% of eyes. Cataracts progression was noted during follow–up in 18.4% of eyes and cataract extraction was performed in 7.4% of eyes. Five eyes (0.3%) developed culture–negative endophthalmitis, and 4 eyes (0.25%) developed moderate intraocular inflammation. A corneal abrasion was noted in 3 eyes (0.2%), which was felt to be a reaction to 10% betadine, and a local scleritis at the injection site was noted in one eye (0.06%). One eye (0.06%) developed a central retinal vein occlusion 3 months after IVT injection. One eye (0.06%), which had previously been treated with a scleral buckle for retinal detachment (RD), developed a recurrent RD, 3 weeks after IVT injection. At 6 months, 25.2% of eyes improved 2 or more lines, 40.1% were the same, and 34.7% of eyes lost 2 or more lines of Snellen visual acuity. Conclusions: The complications of IVT include ocular hypertension, culture–negative endophthalmitis, intraocular inflammation, and progression of cataract. Longer follow–up is needed to evaluate the long–term safety of IVT.

Keywords: clinical (human) or epidemiologic studies: outcomes/complications • drug toxicity/drug effects • injection