Long-term incidence and timing of intraocular hypertension after intravitreal triamcinolone acetonide injection.
OBJECTIVE
To describe the long-term incidence and timing of steroid-induced ocular hypertension after intravitreal triamcinolone acetonide (IVTA) therapy.


METHODS
Retrospective case series of 929 eyes of 841 patients.


METHODS
Patients with a variety of posterior segment disorders in a single group practice.


METHODS
Pars plana injection of IVTA.


METHODS
Intraocular pressure (IOP) and requirement for glaucoma surgery.


RESULTS
Overall, 929 eyes received >or=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.
Roth
Daniel B
DB
Robert Wood Johnson Medical School, New Brunswick, New Jersey 08701, USA. rothretina@gmail.com
Verma
Varun
V
Realini
Tony
T
Prenner
Jonathan L
JL
Feuer
William J
WJ
Fechtner
Robert D
RD
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007267:Injections; D007429:Intraocular Pressure / Q000187:drug effects*; D008297:Male; D009798:Ocular Hypertension / Q000139:chemically induced* / Q000188:drug therapy; D012164:Retinal Diseases / Q000188:drug therapy; D019233:Retreatment; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014222:Triamcinolone Acetonide / Q000009:adverse effects*; D014822:Vitreous Body
D000959:Antihypertensive Agents; D005938:Glucocorticoids; D014222:Triamcinolone Acetonide