July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
A further look at the effects of intravitreal triamcinolone acetonide on intraocular pressure in treatment of macular edema
Author Affiliations & Notes
  • Isha Mehta
    Ophthalmology, St. Johns Episcopal Hospital, Brooklyn, New York, United States
  • Ahmad Rehmani
    Ophthalmology, St. Johns Episcopal Hospital, Brooklyn, New York, United States
  • Jeffrey Freedman
    Ophthalmology Emeritus Professor, SUNY Downstate, New York, United States
  • Robert Feig
    Brooklyn Eye Center, New York, United States
  • Footnotes
    Commercial Relationships   Isha Mehta, None; Ahmad Rehmani, None; Jeffrey Freedman, None; Robert Feig, None
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 2431. doi:
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      Isha Mehta, Ahmad Rehmani, Jeffrey Freedman, Robert Feig; A further look at the effects of intravitreal triamcinolone acetonide on intraocular pressure in treatment of macular edema. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2431.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Increased intraocular pressure is documented as a common side effect of intravitreal triamcinolone injection. We performed a retrospective, noncomparative interventional case series to review the rise of intraocular pressure and rates of induced glaucoma in patients receiving triamcinolone injections.

Methods : Forty-five eyes of thirty-two patients were included. The intraocular pressures were recorded by Tonopen at initial visit before triamcinolone injection and at 1-month intervals after each injection. Our patients ranged from 42 to 84 years old. The cause of macular edema was primarily diabetes (34 eyes), followed by pseudophakic CME (5), central retinal vein occlusion (4), branch retinal vein occlusion (1), and Polypoidal AMD (1). At 3 months, 6 eyes (6 patients) were lost to follow up.

Results : Within 4 weeks of intravitreal triamcinolone acetonide injections 11/45 eyes (24.4%) demonstrated an increase in IOP of 6mm Hg or greater and IOP above 21 mm Hg. Within 8 and 12 weeks respectively, the number fell to 7/43 (16.2%) and 4/38 eyes (10.5%) of eyes. Of 11.1% of patients started on IOP lowering medications for secondary glaucoma, only 4.4% required IOP lowering drops at 3 months. Overall IOP increased (p<0.001) from mean preoperative IOP 14.87 mm hg (n = 45) and the maximum post injection IOP 19.74 mm hg (n = 45). 37.5% of patients with known glaucoma had IOP increase of 6mm Hg or greater and IOP above 21.

Conclusions : Our results show the incidence of intraocular pressure increase following triamcinolone injection is significantly less than has been reported. Patients already with known glaucoma may be more prone to IOP spike following triamcinolone injections.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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