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Intraocular pressure elevation after intravitreal or posterior sub-Tenon triamcinolone acetonide injection.
Can J Ophthalmol 2008; 43(1):42-7CJ

Abstract

BACKGROUND

Despite the benefits of intraocular steroids for the treatment of inflammatory, neovascular, proliferative, and edematous diseases, one of the side effects is raised intraocular pressure (IOP). In this study, we attempted to identify when IOP elevates, peaks, and returns to the preinjection baseline IOP after intravitreal or posterior sub-Tenon administration of triamcinolone acetonide, as well as the factors that might affect IOP.

METHODS

Retrospective case review was undertaken of 69 patients (82 eyes), who received either a 4 mg intravitreal (16 eyes) or a 20 mg posterior sub-Tenon (66 eyes) triamcinolone acetonide injection. IOP assessment for each eye was completed at the preinjection baseline and at the first, third, and sixth month of follow-up.

RESULTS

The mean IOP of all eyes increased significantly at each follow-up. The mean maximum elevation ratio from the baseline was 4.0 (SD 5.2) mm Hg. An elevation of 5 mm Hg or greater occurred in 28 eyes (34.1%). The maximum elevation correlated significantly with age (p < 0.01). The incidence of an elevation of 5 mm Hg or greater was significantly higher among patients younger than 60 years (p < 0.01) and relatively higher among female patients (p = 0.051). The mean IOP increased significantly at the first month after intravitreal injection but at all follow-up periods after posterior sub-Tenon injection. There was no significant difference in IOP elevation according to disease type, although eyes with diabetic retinopathy tended to be at higher risk of IOP elevation. Two eyes of two female patients, who had received posterior sub-Tenon injections for the treatment of diabetic retinopathy, required glaucoma surgery.

INTERPRETATION

The IOP elevation of 5 mm Hg or greater observed in 34.1% of the eyes was consistent with past reports. IOP elevation was associated with patients of less than 60 years of age and with female sex, and it lasted longer after posterior sub-Tenon injection than after intravitreal injection. Careful assessment of IOP during a follow-up period of at least 6 months is paramount, especially in younger female patients after posterior sub-Tenon injection.

Authors+Show Affiliations

Department of Ophthalmology and Visual Science, Kochi Medical School, Kohasu, Nankoku City, Japan. hiroyumi@orange.ocn.ne.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18204501

Citation

Yamamoto, Yumiko, et al. "Intraocular Pressure Elevation After Intravitreal or Posterior sub-Tenon Triamcinolone Acetonide Injection." Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie, vol. 43, no. 1, 2008, pp. 42-7.
Yamamoto Y, Komatsu T, Koura Y, et al. Intraocular pressure elevation after intravitreal or posterior sub-Tenon triamcinolone acetonide injection. Can J Ophthalmol. 2008;43(1):42-7.
Yamamoto, Y., Komatsu, T., Koura, Y., Nishino, K., Fukushima, A., & Ueno, H. (2008). Intraocular pressure elevation after intravitreal or posterior sub-Tenon triamcinolone acetonide injection. Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie, 43(1), pp. 42-7. doi:10.3129/i07-186.
Yamamoto Y, et al. Intraocular Pressure Elevation After Intravitreal or Posterior sub-Tenon Triamcinolone Acetonide Injection. Can J Ophthalmol. 2008;43(1):42-7. PubMed PMID: 18204501.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intraocular pressure elevation after intravitreal or posterior sub-Tenon triamcinolone acetonide injection. AU - Yamamoto,Yumiko, AU - Komatsu,Tsutomu, AU - Koura,Yuji, AU - Nishino,Koji, AU - Fukushima,Atsuki, AU - Ueno,Hisayuki, PY - 2008/1/22/pubmed PY - 2008/4/18/medline PY - 2008/1/22/entrez SP - 42 EP - 7 JF - Canadian journal of ophthalmology. Journal canadien d'ophtalmologie JO - Can. J. Ophthalmol. VL - 43 IS - 1 N2 - BACKGROUND: Despite the benefits of intraocular steroids for the treatment of inflammatory, neovascular, proliferative, and edematous diseases, one of the side effects is raised intraocular pressure (IOP). In this study, we attempted to identify when IOP elevates, peaks, and returns to the preinjection baseline IOP after intravitreal or posterior sub-Tenon administration of triamcinolone acetonide, as well as the factors that might affect IOP. METHODS: Retrospective case review was undertaken of 69 patients (82 eyes), who received either a 4 mg intravitreal (16 eyes) or a 20 mg posterior sub-Tenon (66 eyes) triamcinolone acetonide injection. IOP assessment for each eye was completed at the preinjection baseline and at the first, third, and sixth month of follow-up. RESULTS: The mean IOP of all eyes increased significantly at each follow-up. The mean maximum elevation ratio from the baseline was 4.0 (SD 5.2) mm Hg. An elevation of 5 mm Hg or greater occurred in 28 eyes (34.1%). The maximum elevation correlated significantly with age (p < 0.01). The incidence of an elevation of 5 mm Hg or greater was significantly higher among patients younger than 60 years (p < 0.01) and relatively higher among female patients (p = 0.051). The mean IOP increased significantly at the first month after intravitreal injection but at all follow-up periods after posterior sub-Tenon injection. There was no significant difference in IOP elevation according to disease type, although eyes with diabetic retinopathy tended to be at higher risk of IOP elevation. Two eyes of two female patients, who had received posterior sub-Tenon injections for the treatment of diabetic retinopathy, required glaucoma surgery. INTERPRETATION: The IOP elevation of 5 mm Hg or greater observed in 34.1% of the eyes was consistent with past reports. IOP elevation was associated with patients of less than 60 years of age and with female sex, and it lasted longer after posterior sub-Tenon injection than after intravitreal injection. Careful assessment of IOP during a follow-up period of at least 6 months is paramount, especially in younger female patients after posterior sub-Tenon injection. SN - 0008-4182 UR - https://www.unboundmedicine.com/medline/citation/18204501/Intraocular_pressure_elevation_after_intravitreal_or_posterior_sub_Tenon_triamcinolone_acetonide_injection_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0008-4182(08)80042-7 DB - PRIME DP - Unbound Medicine ER -