[Intraocular pressure elevation after subtenon injection of triamcinolone acetonide during uveitis].
BACKGROUND
New therapeutic concepts in the management of ocular inflammation have led to the development of periocular and intravitreal injections. Such treatment modalities can induce intraocular pressure elevation.


METHODS
Periocular injections have been given to patients suffering from strictly unilateral or bilateral but asymmetrical and noninfectious posterior uveitis. A history of corticosteroid-induced glaucoma was a contraindication to such treatment. A retrospective review of cases who were given subtenon triamcinolone acetonide injection between May and October 2001 was undertaken to evaluate the efficacy of the treatment and the risk of intraocular pressure elevation. Ocular pressure was measured before and after the injection and the efficacy of the treatment was evaluated by measurements of visual acuity and fluorescein angiography.


RESULTS
One or several injections were given to 61 patients. Intraocular pressure rose in 13 patients (21.3%). Medical treatment was unsuccessful in three cases and surgical excision of periocular corticosteroid deposit was required. Therefore, intraocular pressure was controlled with no other medication. Treatment was considered effective in 32 patients (52.45%): improvement of visual acuity (more than two lines) or control of inflammation on fluorescein angiography.


CONCLUSIONS
and conclusions: Periocular subtenon injection of triamcinolone acetonide in posterior noninfectious uveitis is a safe procedure. Intraocular pressure elevation is not frequent and can be controlled through medical treatment or surgical excision of a residual deposit, in which pharmacologically active triamcinolone can be present several months after the injection.
Bui Quoc
E
E
Service d'Ophtalmologie, Groupe Hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'hôpital, 75651 Paris cedex 13, France.
Bodaghi
B
B
Adam
R
R
Burtin
T
T
Cassoux
N
N
Dreifuss
S
S
Fardeau
C
C
LeHoang
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000139:chemically induced*; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000009:adverse effects*; D014605:Uveitis / Q000188:drug therapy*
D000893:Anti-Inflammatory Agents; D014222:Triamcinolone Acetonide