Ocular morbidity associated with intravitreal triamcinolone acetonide.
OBJECTIVE
To report on the complications associated with the use of intravitreal triamcinolone acetonide (IVTA) in a tertiary referral hospital setting.


METHODS
A retrospective case series review of all IVTA injections carried out over a period of 30 months.


RESULTS
One hundred and thirty IVTA injections were performed; nine with limited local follow-up were excluded. Thus, 121 injections (108 patients, 114 eyes) were included in the study. Triamcinolone (4 mg) was used in all cases. Indications were diabetic macular oedema (n=41 eyes), retinal vein occlusions (n=27), postoperative cystoid macular oedema (n=24), exudative age-related macular degeneration (n=16), and others (n=6). No intraoperative complications were recorded. Postoperative intraocular pressure (IOP) readings of 22, 28, 35, and 40 mmHg or higher were recorded in 46.5, 29.8, 12.3, and 7.9% of eyes, respectively. IOP elevation was treated with antiglaucoma medication in all but one eye (0.9%) that required trabeculectomy and one (0.9%) that required vitrectomy with cataract extraction for suspected phacoanaphylactic glaucoma. Two eyes (1.8%) developed retinal detachment; both had previously been treated for retinal breaks. One eye (0.9%) developed culture-positive endophthalmitis.


CONCLUSIONS
Significant morbidity is associated with IVTA injection; clinicians should be aware when considering treatment options.
Konstantopoulos
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Southampton Eye Unit, Southampton University Hospitals NHS Trust, Southampton, Hampshire, UK. ariskons@yahoo.com
Williams
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Newsom
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Luff
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects; D003930:Diabetic Retinopathy / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D009877:Endophthalmitis / Q000139:chemically induced; D017889:Exfoliation Syndrome / Q000150:complications / Q000503:physiopathology; D005128:Eye Diseases / Q000139:chemically induced* / Q000503:physiopathology; D005260:Female; D005901:Glaucoma / Q000150:complications / Q000503:physiopathology; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007267:Injections / Q000379:methods; D007429:Intraocular Pressure / Q000187:drug effects; D008269:Macular Edema / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012163:Retinal Detachment / Q000139:chemically induced; D012164:Retinal Diseases / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D012189:Retrospective Studies; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000009:adverse effects*; D014822:Vitreous Body
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D014222:Triamcinolone Acetonide