Early rapid rise in intraocular pressure after intravitreal triamcinolone acetonide injection

Singh, Inder Paul; Shadi, Ahmad; Yeh, David L.; Challa, Pratap; Herndon, Leon W.; Allingham, R Rand; Lee, Paul P.

doi:10.1016/j.ajo.2004.03.001

Cited by 120 publications

(61 citation statements)

References 2 publications

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“…This possibility is supported by clinical observations (13,16,25), and by the finding that TA inhibits RPE and retinal glial cell proliferation in vitro (26). Corticosteroids are known to elevate IOP in susceptible patients, much like the elevation of IOP observed in some eyes following TA injection (27)(28)(29)(30). In cases where TA is used as an adjuvant, our experience suggests that such elevation of postoperative IOP is considered satisfactory (13)(14)(15)(16).…”

Section: Discussionsupporting

confidence: 67%

Long-Term Clinical Outcomes and Therapeutic Benefits of Triamcinolone-Assisted Pars Plana Vitrectomy for Proliferative Vitreoretinopathy: A Case Study

Ueno

Enaida

Hata

et al. 2007

European Journal of Ophthalmology

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Purpose. To investigate intraoperative visibility and long-term clinical outcome following triamcinolone acetonide (TA)-assisted pars plana vitrectomy (PPV) for proliferative vitreoretinopathy (PVR). Methods. A retrospective interventional noncomparative clinical study was carried out on 21 eyes from 21 patients with more than grade C2 PVR, all of whom underwent TA-assisted PPV. Two of the specimens were observed with an electron microscope. After treatment, outcome measures, including changes in best-corrected visual acuity (BCVA), intraocular pressure (IOP) elevation, corneal pathology, and occurrence of endophthalmitis, were recorded. Patient follow-up time was >36 months (mean ± standard deviation = 47.3 ± 6.7 months). Results. TA improved the intraoperative visualization of the epiretinal membrane (ERM), allowing it to be easily removed together with the partially internal limiting membrane (ILM) using microforceps. The excised tissue consisted of proliferative cells and an extracellular matrix underlying the ILM. After the operation, 71.4% of the eyes had improved BCVA. Three of the eyes showed sustained IOP elevation (14.3%); two of these cases were controlled by the administration of eyedrops, while the third required filtering surgery. In two cases, an absorption delay of the TA granule on the retinal surface was observed. One eye developed corneal stromal opacity. No other severe complications occurred during the observation period. Conclusions. TA-assisted PPV offers improved visualization during the surgical management of PVR, and allows surgeons to excise the ERM safely and effectively without the risk of serious complications.

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Section: Discussionsupporting

confidence: 67%

Long-Term Clinical Outcomes and Therapeutic Benefits of Triamcinolone-Assisted Pars Plana Vitrectomy for Proliferative Vitreoretinopathy: A Case Study

Ueno

Enaida

Hata

et al. 2007

European Journal of Ophthalmology

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“…The mechanical obstruction of the trabecular meshwork by the corticosteroid material or its vehicle may also contribute to the rise in IOP. An early and rapid rise in IOP developing within 1 week and associated with white material within the angle after an intravitreal triamcinolone injection has recently been reported [7]. In our cases, however, the gonioscopy revealed an open angle with absence of triamcinolone accumulation in the anterior chamber.…”

Section: Discussioncontrasting

confidence: 37%

Refractory Severe Ocular Hypertension after Intravitreal Triamcinolone Acetonide Injection

et al. 2005

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Purpose: To report a serious complication following intravitreal triamcinolone acetonide injection. Methods: Observational case report. Results: In 2 patients, secondary intractable severe ocular hypertension occurred 2 months after a single 4-mg intravitreal injection of triamcinolone acetonide for macular edema. Both patients required trabeculectomy intervention to control intraocular pressure (IOP). Conclusion: We highlight the occurrence of intractable high IOP elevation as a serious complication 2 months after intravitreal triamcinolone ace- tonide. Cautious monitoring of IOP for several months after this therapy is recommended. The risks of this potentially devastating complication need to be weighed against the benefits of intravitreal triamcinolone in the individual patient.

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“…One of the two most common side effects of IVTA is the steroid-induced elevation of intraocular pressure [106,293,294,295,296,297,298,299,300,301,302,303,304,305,306]. A prospective clinical interventional comparative nonrandomized study included 260 consecutive patients (293 eyes) receiving an intravitreal injection of 20–25 mg of TA as treatment for diffuse DME, exudative AMD, retinal vein occlusions, uveitis and cystoid macular edema [300].…”

Section: Adverse Eventsmentioning

confidence: 99%

Intravitreal Triamcinolone

Tao

Jonas

2010

Ophthalmologica

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Background: To provide an update on the intravitreal use of triamcinolone acetonide. Methods: Review of literature regarding triamcinolone-related research. Results: After the introduction of bevacizumab and ranibizumab into clinical practice, intravitreal triamcinolone has lost its leading position as the drug most often injected intravitreally. Due to its properties as a long-acting steroid, triamcinolone has still been used for various conditions such as diffuse diabetic macular edema, retinal vein occlusions, pseudophakic cystoid macular edema, chronic prephthisical ocular hypotony and uveitis, and in combination with bevacizumab or ranibizumab. The complications of intravitreal triamcinolone therapy include secondary ocular hypertension in about 40% of the eyes injected, cataract and postoperative infectious or noninfectious endophthalmitis. Conclusions: Due to its widespread biological effects as a steroid and due to a relatively large therapeutic window, intravitreal triamcinolone has remained in clinical use for a variety of intraocular disorders, and it may be a promising candidate for intravitreal medical combination therapies.

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Early rapid rise in intraocular pressure after intravitreal triamcinolone acetonide injection

Cited by 120 publications

References 2 publications

Long-Term Clinical Outcomes and Therapeutic Benefits of Triamcinolone-Assisted Pars Plana Vitrectomy for Proliferative Vitreoretinopathy: A Case Study

Long-Term Clinical Outcomes and Therapeutic Benefits of Triamcinolone-Assisted Pars Plana Vitrectomy for Proliferative Vitreoretinopathy: A Case Study

Refractory Severe Ocular Hypertension after Intravitreal Triamcinolone Acetonide Injection

Intravitreal Triamcinolone

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