Cataract formation and other complications of intravitreal triamcinolone for macular edema.
OBJECTIVE
To evaluate complications and results of intravitreal triamcinolone acetonide for treatment of macular edema.


METHODS
Interventional, consecutive, retrospective case series.


METHODS
Ninety-three eyes with macular edema arising from retinovascular etiologies were treated with 4 mg intravitreal triamcinolone. Eyes were monitored after injection for visual acuity changes and complications, including cataract formation and increase in intraocular pressure (IOP). Cataract progression was analyzed by linear regression analysis of lens scores from lens opacity standards.


RESULTS
The mean visual acuity improved from 20/125 to -1 to 20/100 + 2 by one to two months after injection (P < .001) and was 20/100 at the final examination (P = .006) at a mean of 1.2 years after injection. Complications included a severe, culture-negative inflammatory reaction in one eye (1.1%). IOP increased to 30 mm Hg or more in nine (9.7%) of 93 eyes between 1 and 140 days after injection and was more frequent in eyes receiving one or more preinjection glaucoma drops (two of 13 eyes, 15.4%, vs seven of 80 eyes, 8.75%, without preinjection glaucoma drops). Nuclear sclerosis increased at a rate of 0.175 U per year, posterior subcapsular cataracts at 0.423 U per year, and cortical cataracts at 0.045 U per year. Posterior subcapsular cataract increased by > or = 1 U or required cataract surgery in 45.2% of eyes followed at least one year.


CONCLUSIONS
Intravitreal triamcinolone improves visual acuity in most eyes but eyes must be monitored carefully for increase in IOP. Posterior subcapsular cataract formation becomes visually significant in almost half of eyes by one year after injection.
Greater Baltimore Medical Center, Baltimore, Maryland, USA. JThompson@retinaspec.com
John T
JT
Thompson
D000368:Aged; D002386:Cataract / Q000139:chemically induced*; D018450:Disease Progression; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D007267:Injections; D007429:Intraocular Pressure / Q000187:drug effects; D007908:Lens, Crystalline / Q000187:drug effects*; D008269:Macular Edema / Q000188:drug therapy*; D012189:Retrospective Studies; D013997:Time Factors; D014222:Triamcinolone Acetonide / Q000009:adverse effects*; D014792:Visual Acuity / Q000187:drug effects; D014822:Vitreous Body
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide