title: Severe intraocular pressure rise following intravitreal triamcinolone: a national survey to estimate incidence and describe case profiles.
abstract: OBJECTIVE
  The objective of this study is to estimate the incidence of steroid-induced severe intraocular pressure (IOP) rise following intravitreal triamcinolone acetonide (IVTA) injection and to describe case profiles of the patients affected within the United Kingdom.
  
  
  METHODS
  A national survey was carried out to identify cases that had developed severe IOP rise requiring laser or surgery following IVTA through the British Ophthalmic Surveillance Unit. Respondents were mailed a questionnaire and with a follow-up questionnaire 1 year later, to ascertain characteristics of the patients identified. We also carried out a midpoint survey to ascertain national practice of IVTA at the time.
  
  
  RESULTS
  There were 29 confirmed reports of severe IOP rise after IVTA in the 13-month period of surveillance. All the cases were unilateral and the mean time between the IVTA and the maximum recorded IOP was 16 weeks. Six of these patients had pre-existing glaucoma or ocular hypertension, and a further two were known to be 'steroid responders'. Using the adjusted denominators, obtained from our national survey, the estimated annual incidence would be between 3.6 and 9.5 per 1000 injections.
  
  
  CONCLUSIONS
  These results confirm that severe IOP rise after IVTA is an uncommon but serious complication. Data obtained from this national study should aid clinicians in choosing the treatment best suited to their patients.
authors.affiliation: Department of Ophthalmology, Royal Free Hospital, Royal Free Hampstead NHS Trust, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Jain
authors.affiliation: University of Leicester, Leicester, UK.
authors.forename: J R
authors.initials: JR
authors.lastname: Thompson
authors.affiliation: Royal College of Ophthalmologists, London, UK.
authors.forename: B
authors.initials: B
authors.lastname: Foot
authors.affiliation: University of Leicester, Leicester, UK.
authors.forename: A
authors.initials: A
authors.lastname: Tatham
authors.affiliation: Department of Ophthalmology, Norwich and Norfolk University Hospital, Norwich, UK.
authors.forename: T
authors.initials: T
authors.lastname: Eke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000139:chemically induced* / Q000453:epidemiology; D014221:Triamcinolone / Q000008:administration & dosage / Q000009:adverse effects*; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D014221:Triamcinolone