Abstract
Purpose :
Ocular steroid therapy is often used for its anti-inflammatory mechanism of action, but often resulting in an undesirable increase in the intraocular pressure (IOP) of the treated eye. This study sought to analyze the effects on IOP following intravitreal delivery of triamcinolone acetonide (TRI) injections.
Methods :
The practice management system at Retina Associates of Cleveland was used to gather patients receiving a series of 2 or 3 intravitreal injections of TRI between 2011 and 2023. Using a retrospective cohort analysis, the IOP measurements were collected and analyzed for both treated and fellow eyes. The mean and median baseline visit was compared to the mean and median IOP at the final visit. Likewise, the number of glaucoma medications for both treated and fellow eyes was measured at baseline and compared to the number at the final visit. The mean and median IOP and number of glaucoma medications at the baseline and final visit were calculated and compared using a t-test. The Institutional Review Board granted this study a waiver of authorization.
Results :
A total of 146 patients with a mean age of 69.8 received 2 or 3 treatments of TRI. Data collected showed the mean IOP at baseline was 15.3 mmHg (median 14 mmHg) for the treated eye and 16.7 mmHg (median 16 mmHg) for the fellow eye. At the final visit, the mean IOP was 14.5 mmHg (median 14.5 mmHg) for the treated eye and 16.8 mmHg (median 17.5 mmHg) for the fellow eye. These IOP changes were found to be insignificant (p = 0.71 and 0.92 for treated and fellow eye, respectively). The mean number of glaucoma medications at baseline was 0.26 for the treated eye and 0.21 for the fellow eye which was insignificant (p = 0.3). At the final visit, the mean number of glaucoma medications was 0.21 for the treated eye and 0.12 for the untreated eye which was a statistically significant difference (p = 0.03).
Conclusions :
In this limited analysis, TRI does not appear to cause significant steroid related elevation of IOP. However, a partial explanation for this lack of elevation in IOP can be explained by the significant increase in IOP-lowering medications for treated eyes at the final visit. It is unclear if clinicians were prophylactically treating eyes treated with TRI, but this is also plausible. Further study with longer follow up periods or additional injections could be enlightening.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.