Intraocular pressure elevation after intravitreal triamcinolone acetonide injection

Purpose: To report on intraocular pressure (IOP) after intravitreal injections of triamcinolone acetonide. Design: Meta-analysis of previously reported data and case series studies. Participants: The study included 272 patients (305 eyes) receiving an intravitreal injection of approximately 20 mg triamcinolone acetonide as treatment for diffuse diabetic macular edema (n = 84 patients), exudative age-related macular degeneration (n = 181 patients), retinal vein occlusions (n = 20 patients), uveitis (n = 9), pseudophakic cystoid macular edema (n = 6), and other reasons (n = 5). Mean follow-up was 10.4 +/- 6.7 months (median, 7.9 months; range, 3.0-35.7 months). Intervention: Intravitreal injection of approximately 20 mg triamcinolone acetonide. Main Outcome Measure: Intraocular pressure. Results: Intraocular pressure readings higher than 21 mmHg, 30 mmHg, 35 mmHg, and 40 mmHg, respectively, were measured in 112 (41.2%) patients, 31 (11.4%) patients, 15 (5.5%) patients, and 5 (1.8%) patients, respectively. Triamcinolone-incluced IOP elevation was treated by antiglaucoma medication in all but 3 (1.0%) eyes, for which filtering surgery was performed. Mean IOP started to rise 1 week after injection and returned to baseline values approximately 8 to 9 months after injection. Younger age (P = 0.029) was significantly associated with triamcinolone-induced ocular hypertension. Triamcinolone responders and triamcinolone nonresponders did not vary significantly in gender (P = 0.42), refractive error (P = 0.86), diabetes mellitus status (P = 0.74), and reason for treatment. Conclusions: These findings may be useful for comparing risks and benefits of intravitreal triamcinolone acetonide therapy. (c) 2005 by the American Academy of Ophthalmology.