Intraocular Pressure Increases After Intraarticular Knee Injection With Triamcinolone but Not Hyaluronic Acid

Abstract

Level II, therapeutic study.

CORR Insights®: Intraocular Pressure Increases After Intraarticular Knee Injection With Triamcinolone but Not Hyaluronic Acid

“…I n the current study, Taliaferro and colleagues [11] show that all interventions, even seemingly lowrisk corticosteroid injections for knee arthritis, can have unanticipated side effects. The well-known risks of intraarticular corticosteroid injection include infection, bleeding, steroid flare reaction, glycemic lability in patients with diabetes, skin discoloration, and skin/subcutaneous fat atrophy [10].…”

“…The current study design measured intraocular pressure [11], which is a surrogate for risk of optic nerve injury and visual field damage. Historically, ophthalmologists screened for optic nerve damage using slit lamp examinations and subjective visual field testing, both of which are not sensitive for detecting early damage.…”

“…The well-known risks of intraarticular corticosteroid injection include infection, bleeding, steroid flare reaction, glycemic lability in patients with diabetes, skin discoloration, and skin/subcutaneous fat atrophy [10]. Although intraocular pressure elevation is not a well-described side effect of intraarticular corticosteroid injection, Taliaferro and colleagues found that nearly 30% of patients undergoing intraarticular knee corticosteroid injections demonstrate increased intraocular pressure (> 7 mm Hg) at 1 week after the injection, which remains elevated in about half of those patients at 1 month [11].…”

Serial Intralesional Steroid Injection for Subglottic Stenosis: Systemic Side Effects and Impact on Surgery‐Free Interval

“… 28 , 29 Increased IOP is seen in triamcinolone intra-articular knee injection and oral steroid treatment, at a rate of 25% to 29%. 30 One patient in our cohort experienced increased IOP and was receiving simultaneous knee injections of an unknown dose, which may have been the primary etiology or at least a contributor to her total systemic dosage. Central serous chorioretinopathy may also be caused by intra-articular, inhaled, and epidural steroid administration.…”

Intra‐articular spine injections of steroid as a contributing factor to glaucoma

“…However, iCorticosteroid can cause a rise in IOP within a few weeks of commencement, but typically the pressures return to normal on cessation of treatment. Intraarticular corticosteroid injection causing elevated IOP is an extremely rare phenomenon , but has been previously documented in the literature (2,3). To our knowledge, wWe describe present the firsta case of of a patient who received intra-articular glucocorticoids resulting in steroid-induced glaucoma.…”