Long-Term Incidence and Timing of Intraocular Hypertension after Intravitreal Triamcinolone Acetonide Injection

Daniel B. Roth, Varun Verma, Tony Realini, Jonathan L. Prenner, William J Feuer, Robert D. Fechtner

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Abstract

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. Financial Disclosure(s): The authors have no proprietary or commercial interest in any materials discussed in this paper.

Original languageEnglish (US)
Pages (from-to)455-460
Number of pages6
JournalOphthalmology
Volume116
Issue number3
DOIs
StatePublished - Mar 2009

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Triamcinolone Acetonide
Intraocular Pressure
Hypertension
Injections
Incidence
Glaucoma
Steroids
Ocular Hypertension
Group Practice
Intravitreal Injections
Temazepam
Disclosure
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Roth, D. B., Verma, V., Realini, T., Prenner, J. L., Feuer, W. J., & Fechtner, R. D. (2009). Long-Term Incidence and Timing of Intraocular Hypertension after Intravitreal Triamcinolone Acetonide Injection. Ophthalmology, 116(3), 455-460. https://doi.org/10.1016/j.ophtha.2008.10.002

Long-Term Incidence and Timing of Intraocular Hypertension after Intravitreal Triamcinolone Acetonide Injection. / Roth, Daniel B.; Verma, Varun; Realini, Tony; Prenner, Jonathan L.; Feuer, William J; Fechtner, Robert D.

In: Ophthalmology, Vol. 116, No. 3, 03.2009, p. 455-460.

Research output: Contribution to journalArticle

Roth, DB, Verma, V, Realini, T, Prenner, JL, Feuer, WJ & Fechtner, RD 2009, 'Long-Term Incidence and Timing of Intraocular Hypertension after Intravitreal Triamcinolone Acetonide Injection', Ophthalmology, vol. 116, no. 3, pp. 455-460. https://doi.org/10.1016/j.ophtha.2008.10.002
Roth, Daniel B. ; Verma, Varun ; Realini, Tony ; Prenner, Jonathan L. ; Feuer, William J ; Fechtner, Robert D. / Long-Term Incidence and Timing of Intraocular Hypertension after Intravitreal Triamcinolone Acetonide Injection. In: Ophthalmology. 2009 ; Vol. 116, No. 3. pp. 455-460.
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AB - 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. Financial Disclosure(s): The authors have no proprietary or commercial interest in any materials discussed in this paper.

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