May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Intravitreal triamcinolone–induced elevated IOP is strongly associated with accelerated posterior subcapsular cataract progression.
Author Affiliations & Notes
  • M.C. Gillies
    Ophthatlmology, University of Sydney, Sydney, Australia
  • M. Kuzniarz
    Sydney Eye Hospital, Sydney, Australia
  • J. Craig
    Flinders University, Flinders Medical Centre, Adelaide, Australia
  • M. Ball
    Sydney Eye Hospital, Sydney, Australia
  • W. Luo
    Ophthatlmology, University of Sydney, Sydney, Australia
  • S. Judy
    Ophthatlmology, School of Public Health, Sydney, Australia
  • Footnotes
    Commercial Relationships  M.C. Gillies, RETMED P; M. Kuzniarz, None; J. Craig, None; M. Ball, None; W. Luo, None; S. Judy, None.
  • Footnotes
    Support  JDRF GRANT
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 1932. doi:
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      M.C. Gillies, M. Kuzniarz, J. Craig, M. Ball, W. Luo, S. Judy; Intravitreal triamcinolone–induced elevated IOP is strongly associated with accelerated posterior subcapsular cataract progression. . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1932.

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Abstract

Abstract: : Purpose: To investigate the association between elevated intraocular pressure (IOP) and accelerated cataract formation in patients treated with intravitreal triamcinolone. Methods: Analysis of longitudinal data from a randomized, double masked placebo controlled trial of intravitreal triamcinolone for age–related macular degeneration. Patients with phakic eyes who participated in a randomized clinical trial of intravitreal triamcinolone for age related macular degeneration were studied. There were 57 phakic eyes in the treatment group and 54 phakic eyes in the control group. The main outcome measures were: intraocular pressure rise of at least 5mmHg (IOP responders) and progression of posterior subcapsular cataract by 2 or more grades using photographic standards from the Age Related Eye Disease Study. Results: Progression of posterior subcapsular cataract (PSC) by 2 or more grades in the treatment group was significantly higher among 18 IOP responders (50%) than among 35 non–responders (0%) (P <0.0001). There was no significant progression of PSC in the placebo group or the opposite eye of the treatment group. The progression of cortical (17% v 3%) or nuclear cataracts (6% v 0%) was not significantly different between IOP responders and non–responders. Conclusions:While eyes that do not experience elevated IOP after intravitreal triamcinolone are unlikely to develop steroid–related cataract, those that do have a very high risk of rapidly developing posterior subcapsular lens opacification. This strong association suggests that the mechanism responsible for the development of steroid–induced PSC and raised IOP may be similar.

Keywords: clinical (human) or epidemiologic studies: outcomes/complications • corticosteroids • cataract 
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