title: Intraocular pressure rise is predictive of vision improvement after intravitreal triamcinolone acetonide for diabetic macular oedema: a retrospective analysis of data from a randomised controlled trial.
abstract: BACKGROUND
  Intravitreal triamcinolone acetonide (IVTA) is an effective treatment for recalcitrant diabetic macular oedema (DMO). It has been shown to improve vision with benefits persisting up to five years. The most common initial side effect of IVTA treatment is rise in intraocular pressure, occurring in approximately 50% of patients within the first 6 months of treatment. We evaluated whether there is a correlation between the development of intraocular pressure rise and improvement in vision.
  
  
  METHODS
  Analysis of individual data from 33 eyes of 33 participants treated with IVTA for DMO from a prospective, randomised, double-masked, placebo controlled trial. The degree of intraocular pressure (IOP) rise was correlated with improvement in best-corrected visual acuity (BCVA) at 1 and 6 months.
  
  
  RESULTS
  The proportion of eyes gaining 5 or more logMAR letters was higher in eyes with greater IOP rise (p = 0.044). Better absolute improvement in BCVA at 6 months (p = 0.045) was also found in eyes with greater IOP rise. Regression analyses revealed a correlation between IOP rise of 10 or more mmHg and absolute BCVA improvement at 6 months (odds ratio 1.22, 95% confidence interval 1.01-1.48, p = 0.039), but not at 1 month.
  
  
  CONCLUSIONS
  IOP rise and vision improvement appear to be correlated following IVTA for DMO, suggesting that the mechanisms that cause both may be linked.
  
  
  BACKGROUND
  Clinical trials.gov NCT00167518, September 5, 2005.
authors.affiliation: Clinical Ophthalmology & Eye Health, The University of Sydney, Sydney, Australia. roderick.oday@gmail.com.
authors.forename: Roderick F
authors.initials: RF
authors.lastname: O'Day
authors.forename: Daniel
authors.initials: D
authors.lastname: Barthelmes
authors.forename: Meidong
authors.initials: M
authors.lastname: Zhu
authors.forename: Tien Y
authors.initials: TY
authors.lastname: Wong
authors.forename: Ian L
authors.initials: IL
authors.lastname: McAllister
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Arnold
authors.forename: Mark C
authors.initials: MC
authors.lastname: Gillies
mesh_terms: D000368:Aged; D003930:Diabetic Retinopathy / Q000188:drug therapy / Q000503:physiopathology*; D004311:Double-Blind Method; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects* / Q000502:physiology; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014222:Triamcinolone Acetonide / Q000009:adverse effects* / Q000627:therapeutic use; D014792:Visual Acuity / Q000502:physiology*
chemical_list: D005938:Glucocorticoids; D006442:Glycated Hemoglobin; D014222:Triamcinolone Acetonide; C517652:hemoglobin A1c protein, human