A Study on Intraocular Pressure Elevation after Intravitreal 4mg Triamcinolone Acetonide Injection in Treatment of Macular Edema among North India Population
Intraocular Pressure Elevation in macular edema
Background: Macular edema is one of the leading causes for impaired vision in some retinal vascular disorders. Recent clinical studies suggest that intravitreal injection of triamcinolone acetonide (IVTA) may be a therapeutic option for the treatment of macular edema. In 1995, Penfold et al reported a pilot study of intravitreal injection of 4mg of triamcinolone acetonide (IVTA) to treat exudative age-related macular degeneration with encouraging results. Subjects and Methods: A prospective, non-comparative study was performed with 100 patients (100 eyes) who received 4mg/0.1mL (40g/L) IVTA injection for macular edema and who were followed-up for a minimum of 3 months at the Department of Ophthalmology. Patients using steroid eye drops or systemic steroid, those previously treated with subconjunctival or subtenon steroid injection, and those with a history of glaucoma were excluded from the study. Results: Of the 100 eyes, 50 were from women and 50 were from men; the mean age was 56.3±11.4 years. Reason for the IVTA was progressive declining of visual acuity due to macular edema associated with retinal vein occlusion (60 eyes), or diabetic retinopathy (40 eyes). IOP increased significantly (p<0.001) from 14.95±2.83 mmHg preoperatively to a mean maximum of 19.01±5.92 mmHg postoperatively. Conclusion: According to our results, intravitreal injection of 4mg of triamcinolone acetonide can lead to significant IOP elevation in approximately one-third of patients, occurring at a mean of 4 weeks after injection. The findings of our study suggest that the IVTA in a dosage of 4 mg could lead to a secondary ocular hypertension.