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Abstract #22671 Published in IGR 11-1
Long-term incidence and timing of intraocular hypertension after intravitreal triamcinolone acetonide injection
Roth DB; Verma V; Realini T; Prenner JL; Feuer WJ; Fechtner RDOphthalmology 2009; 116: 455-460
PURPOSE: To describe the long-term incidence and timing of steroid-induced ocular hypertension after intravitreal triamcinolone acetonide (IVTA) therapy. DESIGN: Retrospective case series of 929 eyes of 841 patients. PARTICIPANTS: Patients with a variety of posterior segment disorders in a single group practice. INTERVENTION: Pars plana injection of IVTA. MAIN OUTCOME MEASURES: Intraocular pressure (IOP) and requirement for glaucoma surgery. RESULTS: Overall, 929 eyes received ≥1 injections (mean, 1.6) of 4 mg of IVTA. During a mean follow-up period of 14±6.9 months, the Kaplan-Meier cumulative incidences of IOP elevations >21 mmHg at 6, 12, 18, and 24 months post-injection were 28.2%, 34.6%, 41.2%, and 44.6%, respectively; similarly, the incidences of eyes with IOP measurements >25 mmHg were 14.6%, 19.1%, 24.1%, and 28.2%, respectively. At the same time points, IOP-lowering medications were required by 13.0%, 16.9%, 20.7%, and 24.2% of eyes, respectively. Only 3 eyes (0.3%) required IOP-lowering surgery. Preexisting glaucoma, younger age, and a history of an IOP elevation after a previous IVTA injection were risk factors for IOP elevations after IVTA injection. The minimum and maximum follow-up were 3 weeks and 37 months. The mean rate of attrition in this study was 3% per month. CONCLUSIONS: Elevations in IOP after IVTA injection are common. Younger patients and eyes with preexisting glaucoma or a history of a steroid response should be monitored more closely for IOP elevations after IVTA therapy.
Dr. D.B. Troth, Robert Wood Johnson Medical School, New Brunswick, NJ, USA
Classification:
9.4.1 Steroid-induced glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
