Adverse events after intravitreal triamcinolone in patients with and without uveitis.
OBJECTIVE
To evaluate the rates of adverse ocular events after intravitreal triamcinolone acetonide (IVTA) injection in patients with and without uveitis.


METHODS
Retrospective observational case series.


METHODS
Two hundred twenty-two eyes of 173 patients were included in the study: 45 eyes of 31 patients with macular edema (ME) due to uveitis and 177 eyes of 142 patients with ME secondary to other etiologies.


METHODS
Retrospective review of patients who received IVTA at the Cole Eye Institute for ME attributable to various causes between the years 2001 and 2005. Data review of clinical records included patient demographics, etiology of ME, and adverse outcomes after injection. Rates of adverse outcomes in patients with and without uveitis were compared.


METHODS
Intraocular pressure (IOP) elevation and posterior subcapsular cataract (PSC) progression.


RESULTS
Uveitis patients were significantly younger, more likely to be female, and more likely to have had prior posterior sub-Tenon's capsule steroid injection and/or glaucoma therapy than their nonuveitis counterparts. In a multivariate analysis adjusting for the differences in these factors, the presence of uveitis was the strongest risk factor for an adverse IOP event (odds ratio, 2.5; 95% confidence interval [CI], 1.0-6.1; P = 0.05). The odds of having a documented increase in PSC after IVTA injection were 5.6 times greater in uveitis eyes (P = 0.007; 95% CI, 1.6-19.6).


CONCLUSIONS
Intraocular pressure elevation and PSC progression occurred with greater frequency in uveitis patients receiving IVTA. Patients with uveitis treated with IVTA should be counseled about these risks and monitored closely.
Galor
Anat
A
Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA.
Margolis
Ron
R
Brasil
Oswaldo M F
OM
Perez
Victor L
VL
Kaiser
Peter K
PK
Sears
Jonathan E
JE
Lowder
Careen Y
CY
Smith
Scott D
SD
D000368:Aged; D002386:Cataract / Q000139:chemically induced / Q000175:diagnosis; D018450:Disease Progression; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D007267:Injections; D007429:Intraocular Pressure / Q000187:drug effects; D007903:Lens Capsule, Crystalline / Q000187:drug effects; D008269:Macular Edema / Q000188:drug therapy / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014222:Triamcinolone Acetonide / Q000009:adverse effects*; D014605:Uveitis / Q000150:complications*; D014792:Visual Acuity / Q000187:drug effects; D014822:Vitreous Body
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide