Refractory Severe Ocular Hypertension after Intravitreal Triamcinolone Acetonide Injection

Yang, Chi; Chen, Mei Ju; Chou, Chen Kung; Hsu, Wen-Ming

doi:10.1159/000088388

Cited by 10 publications

(3 citation statements)

References 22 publications

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“…Severe and intractable IOP elevations, despite maximally tolerated medical therapy after IVTA, were reported to occur in some eyes, especially those with retinal vein occlusions (Kaushik et al 2004; Yang et al 2005; Quiram et al 2006). The reported treatment methods for secondary ocular hypertension after IVTA were argon laser trabeculoplasty, selective laser trabeculoplasty, trabeculectomy, drainage devices, and pars plana vitrectomy (Agrawal et al 2004; Kaushik et al 2004; Yang et al 2005; Pizzimenti et al 2006; Quiram et al 2006; Sivaprasad et al 2006; Viola et al 2006).…”

Section: Discussionmentioning

confidence: 99%

“…The reported treatment methods for secondary ocular hypertension after IVTA were argon laser trabeculoplasty, selective laser trabeculoplasty, trabeculectomy, drainage devices, and pars plana vitrectomy (Agrawal et al 2004; Kaushik et al 2004; Yang et al 2005; Pizzimenti et al 2006; Quiram et al 2006; Sivaprasad et al 2006; Viola et al 2006). …”

Section: Discussionmentioning

confidence: 99%

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Development of ocular hypertension and persistent glaucoma after intravitreal injection of triamcinolone

Kocabora

Yilmazli²,

Taşkapili³

et al. 2008

OPTH

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PurposeThis study evaluates intraocular pressure (IOP) elevation secondary to intravitreal injection of triamcinolone acetonide (IVTA) and discusses its management.MethodsThe records of 175 patients who underwent IVTA treatment and regular eye examinations in the period 2003–2006 were reviewed. One hundred and twenty-two of these patients were included in the study, of which 147 eyes that received IVTA (4 mg/0.1 ml) were followed for at least 9 months. Mean IOPs observed after IVTA injection as well as IOP elevations defined as moderate (≥5 mm Hg), important (≥10 mm Hg) and severe (>25 mm Hg) during the follow-up period were evaluated and compared statistically.ResultsOverall, the mean IOPs following IVTA injection were statistically significantly higher than the preinjection IOP (15.8 ± 2.6), after the first hour (17.7 ± 2.9), the first week (18.7 ± 4.1), the first month (19.6 ± 6.2), the second month (19.1 ± 6.1), the third month (18.0 ± 4.1), the sixth month (17.3 ± 4.0), and the ninth month (17.0 ± 2.7), but not after the first day (16.3 ± 7.6). Important IOP elevations were observed mostly in the first (17.7%) and second months (10.2%). In 40 (27.7%) eyes, topical antiglaucomatous therapy was needed and 7 later required surgical intervention to lower the IOP. Of the remaining 33 eyes, topical treatment was continued in 14 (9.5%) because of IOPs ≥20 mm Hg.ConclusionThe persistence of IOP elevation beyond the IVTA clearance period and the development of intractable secondary glaucoma requiring surgical intervention substantiate the need for careful consideration of IVTA indication and follow-up.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Development of ocular hypertension and persistent glaucoma after intravitreal injection of triamcinolone

Kocabora

Yilmazli²,

Taşkapili³

et al. 2008

OPTH

View full text Add to dashboard Cite

show abstract

“…While ocular hypertension may be unpredictable, the complication has been statistically associated with high baseline intraocular pressure, younger age, and diabetes mellitus status (Wang 2007). A peak in intraocular pressure is observed approximately two months following intravitreal triamcinolone acetonide treatment (Bashshur 2004;Gelston 2006;Wang 2007;Yang 2005), however there is a need to monitor for intraocular pressure rise beyond six months postinjection (Wang 2007). Transient hypertony is also a concern, occurring in over half of eyes receiving intravitreal triamcinolone acetonide (Table 8).…”

Section: Discussionmentioning

confidence: 99%

Intravitreal steroids versus observation for macular edema secondary to central retinal vein occlusion

Gewaily

Greenberg

2008

Cochrane Database of Systematic Reviews

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Background-Central retinal vein occlusion (CRVO) is a common retinal vascular abnormality associated with conditions such as hypertension, diabetes, glaucoma, and a wide variety of hematologic disorders. Macular edema (ME) represents an important vision-threatening complication of CRVO. There is no proven treatment; laser photocoagulation is not effective in treating cystoid macular edema secondary to CRVO. Intravitreal steroids, such as triamcinolone acetonide, have been utilized to treat macular edema stemming from a variety of etiologies and may represent a treatment option for CRVO-ME. Objectives-The objective of this review was to explore the effectiveness and safety of intravitreal steroids in the treatment of CRVO-ME.

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Intravitreal steroids versus observation for macular edema secondary to central retinal vein occlusion

Gewaily¹,

Greenberg²

2009

Cochrane Database of Systematic Reviews

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Background Central retinal vein occlusion (CRVO) is a common retinal vascular abnormality associated with conditions such as hypertension, diabetes, glaucoma, and a wide variety of hematologic disorders. Macular edema (ME) represents an important vision-threatening complication of CRVO. There is no proven treatment; laser photocoagulation is not effective in treating cystoid macular edema secondary to CRVO. Intravitreal steroids, such as triamcinolone acetonide, have been utilized to treat macular edema stemming from a variety of etiologies and may represent a treatment option for CRVO-ME. Objectives The objective of this review was to explore the effectiveness and safety of intravitreal steroids in the treatment of CRVO-ME. Search strategy We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 4, 2008), MEDLINE (January 1950 to November 2008) and EMBASE (January 1980 to November 2008). There were no language or date restrictions in the search for trials. The electronic databases were last searched on 5 November 2008. For all included primary studies, we used The Science Citation Index and manually reviewed reference lists to identify other possible relevant trials. We contacted researchers in the field, currently working on a randomized controlled trial (RCT) on this topic (The Standard Care versus Corticosteroid for Retinal Vein Occlusion - SCORE study), for information on additional current, past, or unpublished trials. Selection criteria We considered RCTs that compared intravitreal steroids of any dosage/duration to observation in the treatment of CRVO-ME for inclusion in this review. We focused on studies that included individuals of any age or gender with unilateral or bilateral disease, with a minimum of six months follow up. Secondarily we considered non-randomized studies with the same criteria for description of evidence, however we did not conduct a separate electronic search for finding all non-randomized studies. Data collection and analysis We found no RCTs that met the inclusion criteria after independent and duplicate review of the search results. Main results We found no relevant RCTs and therefore performed no meta-analysis. Evidence from non-randomized studies is reported in this review. Authors’ conclusions There is inadequate evidence for the use of intravitreal steroids for CRVO-ME due to a paucity of RCTs and well-designed observational studies on the topic; therefore, it is still an experimental procedure.

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Refractory Severe Ocular Hypertension after Intravitreal Triamcinolone Acetonide Injection

Cited by 10 publications

References 22 publications

Development of ocular hypertension and persistent glaucoma after intravitreal injection of triamcinolone

Development of ocular hypertension and persistent glaucoma after intravitreal injection of triamcinolone

Intravitreal steroids versus observation for macular edema secondary to central retinal vein occlusion

Intravitreal steroids versus observation for macular edema secondary to central retinal vein occlusion

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