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

Abstract

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 56.311.4 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 14.952.83 mmHg preoperatively to a mean maximum of 19.015.92 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.