Abstract
Abstract: :
Purpose: To determine the incidence of intraocular pressure (IOP) elevation following subtenons triamcinolone acetonide (STTA) injection for treatment of macular edema from various causes. Methods: Retrospective chart review of patients who had received STTA during 1/1/02 to 12/31/03 was performed. Intraocular pressure of 25 mmHg or higher at a follow up visit was considered elevated intraocular pressure. Results: Total of 194 injections was given to 140 eyes of 117 patients. At baseline, 10 patients had a diagnosis of primary open angle glaucoma (POAG) and 5 patients had ocular hypertension (OHTN). 15 eyes of 14 patients developed increased IOP. The highest IOP ranged between 25 to 45 mmHg (mean: 31 mmHg). It was detected at a mean of 13.5 weeks after injection (range: 3 weeks to 31weeks). It occurred after the first injection in 13 eyes and after the second injection in 2 eyes. The IOP increase occurred in 9/78 (11.5%) eyes with CME, 6/58 (10.3%) eyes with CSDME, and 0/4 eyes with vein occlusions. Of the 15 eyes that had elevated IOP, 2 eyes had diagnosis of POAG and 2 eyes had diagnosis of OHTN. 7 eyes resolved on their own, 7 eyes responded to topical medications and 1 eye required surgical intervention. The incidence of intraocular pressure elevation after STTA was 15/140 eyes (10.7%). IOP elevation occurred in 4/15 (26.7%) eyes with the diagnosis of OHTN or POAG, while it occurred in 11/125 (8.8%) eyes without prior history of these diagnoses. Therefore, IOP elevation was more common in eyes with a prior diagnosis of POAG or OHTN (P=0.035). Conclusions: The incidence of intraocular pressure elevation after subtenons steroid injection was 10.7%. In 1/140 eyes (0.7%), filtering surgery was required while the others resolved on their own or with topical medications. The pressure elevation was more likely in patients with prior diagnosis of POAG or OHTN.
Keywords: drug toxicity/drug effects • injection • macula/fovea