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Intraocular pressure elevation following triamcinolone acetonide administration as related to administration routes

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the incidence and risk factors of intraocular pressure (IOP) elevation following triamcinolone acetonide (TA) administration.

Methods

In this retrospective observational case series, patients (224 eyes of 202 patients) with diffuse diabetic macular edema (66 eyes), branch retinal vein occlusion (39 eyes), central retinal vein occlusion (25 eyes), exudative age-related macular degeneration (49 eyes), myopic choroidal neovascularization (10 eyes), uveitis (30 eyes), or other conditions (5 eyes) were administered an intravitreal or posterior sub-Tenon capsule injection, or both, of TA. Sub-Tenon capsule injection was performed on 106 eyes (STTA group). Intravitreal injection was performed on 118 eyes (IVTA group), of which 85 eyes underwent simultaneous intravitreal and sub-Tenon capsule injections. Mean follow-up after TA administration was 15.9 ± 10.4 (range, 3–39) months. The sub-Tenon capsule injection and intravitreal injection of TA were compared with respect to the frequency of IOP elevation and the time between TA administration and the initial IOP elevation, and the possible risk factors responsible for IOP elevation were identified.

Results

There was no significant difference in frequency of IOP > 21 mmHg between the STTA group and the IVTA group (P = 0.0588). There was, however, a significant difference in the frequency of IOP > 30 mmHg between the two groups (P = 0.0004). In the IVTA group, more patients needed antiglaucoma medication than in the STTA group (P = 0.0052). The incidence rate of IOP elevation within 1 week after TA administration in the IVTA group was significantly higher than in the STTA group (P = 0.0154). Risk factors for IOP elevation included higher baseline IOP (P < 0.0001), younger patients (P = 0.0095), and simultaneous administration of sub-Tenon capsule and intravitreal injections (P = 0.0228).

Conclusions

Careful follow-up of IOP is required after TA injections.

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References

  1. Jonas JB, Kreissig I, Degenring RF. Intravitreal triamcinolone acetonide for pseudophakic cystoid macular edema. Am J Ophthalmol 2003;136:384–386.

    Article  CAS  Google Scholar 

  2. Okada AA, Wakabayashi T, Morimura Y, et al. Trans-Tenon’s retrobulbar triamcinolone infusion for the treatment of uveitis. Br J Ophthalmol 2003;87:968–971.

    Article  CAS  Google Scholar 

  3. Antcliff RJ, Spalton DJ, Stanford MR, et al. Intravitreal triamcinolone for uveitic cystoid macular edema: an optical coherence tomography study. Ophthalmology 2001;108:765–772.

    Article  CAS  Google Scholar 

  4. Spaide RF, Sorenson J, Maranan L. Combined photodynamic therapy with verteporfin and intravitreal triamcinolone acetonide for choroidal neovascularization. Ophthalmology 2003;110:1517–1525.

    Article  Google Scholar 

  5. Jonas JB, Kreissig I, Sofker A, et al. Intravitreal injection of triamcinolone for diffuse diabetic macular edema. Arch Ophthalmol 2003;121:57–61.

    Article  CAS  Google Scholar 

  6. Park CH, Jaffe GJ, Fekrat S. Intravitreal triamcinolone acetonide in eyes with cystoid macular edema associated with central retinal vein occlusion. Am J Ophthalmol 2003;136:419–425.

    Article  CAS  Google Scholar 

  7. Chen SD, Lochhead J, Patel CK, et al. Intravitreal triamcinolone acetonide for ischaemic macular edema caused by branch retinal vein occlusion. Br J Ophthalmol 2004;88:154–155.

    Article  CAS  Google Scholar 

  8. Jonas JB, Akkoyun I, Kamppeter B, et al. Branch retinal vein occlusion treated by intravitreal triamcinolone acetonide. Eye 2005;19:65–71.

    Article  CAS  Google Scholar 

  9. Jonas JB, Kreissig I, Degenring R. Intraocular pressure after intravitreal injection of triamcinolone acetonide. Br J Ophthalmol 2003;87:24–27.

    Article  CAS  Google Scholar 

  10. Bakri SJ, Beer PM. The effect of intravitreal triamcinolone acetonide on intraocular pressure. Ophthalmic Surg Lasers Imaging 2003;34:386–390.

    PubMed  Google Scholar 

  11. Massin P, Audren F, Haouchine B, et al. Intravitreal triamcinolone acetonide for diabetic diffuse macular edema. Ophthalmology 2004;111:218–224.

    Article  Google Scholar 

  12. Singh IP, Ahmad SI, Yeh D, et al. Early rapid rise in intraocular pressure after intravitreal triamcinolone acetonide injection. Am J Ophthalmol 2004;138:286–287.

    Article  Google Scholar 

  13. Smithen LM, Ober MD, Maranan L, et al. Intravitreal triamcinolone acetonide and intraocular pressure. Am J Ophthalmol 2004;138:740–743.

    Article  CAS  Google Scholar 

  14. Levin DS, Han DP, Dev S, et al. Subtenon’s depot corticosteroid injections in patients with a history of corticosteroid-induced intraocular pressure elevation. Am J Ophthalmol 2002;133:196–202.

    Article  CAS  Google Scholar 

  15. Mueller AJ, Jian G, Banker AS, et al. The effect of deep posterior subtenon injection of corticosteroids on intraocular pressure. Am J Ophthalmol 1998;125:158–163.

    Article  CAS  Google Scholar 

  16. Moshfeghi DM, Kaiser PK, Scott IU, et al. Acute endophthalmitis following intravitreal triamcinolone acetonide injection. Am J Ophthalmol 2003;136:791–796.

    Article  CAS  Google Scholar 

  17. Jonas JB, Degenring RF, Kreissig I, et al. Intraocular pressure elevation after intravitreal triamcinolone acetonide injection. Ophthalmology 2005;112:593–598.

    Article  Google Scholar 

  18. Iwao K, Inatani M, Kawaji T, et al. Frequency and risk factors for intraocular pressure elevation after posterior sub-Tenon capsule triamcinolone acetonide injection. J Glaucoma 2007;16:251–256.

    Article  Google Scholar 

  19. Shukla D, Vidhya N, Prasad NM, et al. Evaluation of patient age as a risk factor for intraocular pressure elevation after intravitreal triamcinolone. Am J Ophthalmol 2007;144:453–454.

    Article  CAS  Google Scholar 

  20. Yamamoto Y, Komatsu T, Koura Y, et al. Intraocular pressure elevation after intravitreal or posterior sub-Tenon triamcinolone acetonide injection. Can J Ophthalmol 2008;43:42–47.

    Article  Google Scholar 

  21. Inatani M, Iwao K, Kawaji T, et al. Intraocular pressure elevation after injection of triamcinolone acetonide: a multicenter retrospective case-control study. Am J Ophthalmol 2008;145:676–681.

    Article  CAS  Google Scholar 

  22. Lau LI, Chen KC, Lee FL, et al. Intraocular pressure elevation after intravitreal triamcinolone acetonide injection in a Chinese population. Am J Ophthalmol 2008;146:573–578.

    Article  CAS  Google Scholar 

  23. Galor A, Margolis R, Brasil OM, et al. Adverse events after intravitreal triamcinolone in patients with and without uveitis. Ophthalmology 2007;114:1912–1918.

    Article  Google Scholar 

  24. Rhee DJ, Peck RE, Belmont J, et al. Intraocular pressure alterations following intravitreal triamcinolone acetonide. Br J Ophthalmol 2006;90:999–1003.

    Article  CAS  Google Scholar 

  25. Hirooka K, Shiraga F, Tanaka S, et al. Risk factors for elevated intraocular pressure after trans-tenon retrobulbar injections of triamcinolone. Jpn J Ophthalmol 2006;50:235–238.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

    Yoshio Hirano, Takeshi Ito, Miho Nozaki, Tsutomu Yasukawa, Eiji Sakurai, Munenori Yoshida & Yuichiro Ogura

  2. Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan

    Yoshio Hirano

Authors
  1. Yoshio Hirano
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  2. Takeshi Ito
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  3. Miho Nozaki
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  4. Tsutomu Yasukawa
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  5. Eiji Sakurai
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  6. Munenori Yoshida
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  7. Yuichiro Ogura
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Correspondence to Yoshio Hirano.

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Hirano, Y., Ito, T., Nozaki, M. et al. Intraocular pressure elevation following triamcinolone acetonide administration as related to administration routes. Jpn J Ophthalmol 53, 519–522 (2009). https://doi.org/10.1007/s10384-009-0692-5

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  • DOI: https://doi.org/10.1007/s10384-009-0692-5

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