Ocular morbidity associated with intravitreal triamcinolone acetonide

Eye (Lond). 2007 Mar;21(3):317-20. doi: 10.1038/sj.eye.6702416. Epub 2006 May 19.

Abstract

Aim: To report on the complications associated with the use of intravitreal triamcinolone acetonide (IVTA) in a tertiary referral hospital setting.

Materials and methods: A retrospective case series review of all IVTA injections carried out over a period of 30 months.

Results: One hundred and thirty IVTA injections were performed; nine with limited local follow-up were excluded. Thus, 121 injections (108 patients, 114 eyes) were included in the study. Triamcinolone (4 mg) was used in all cases. Indications were diabetic macular oedema (n=41 eyes), retinal vein occlusions (n=27), postoperative cystoid macular oedema (n=24), exudative age-related macular degeneration (n=16), and others (n=6). No intraoperative complications were recorded. Postoperative intraocular pressure (IOP) readings of 22, 28, 35, and 40 mmHg or higher were recorded in 46.5, 29.8, 12.3, and 7.9% of eyes, respectively. IOP elevation was treated with antiglaucoma medication in all but one eye (0.9%) that required trabeculectomy and one (0.9%) that required vitrectomy with cataract extraction for suspected phacoanaphylactic glaucoma. Two eyes (1.8%) developed retinal detachment; both had previously been treated for retinal breaks. One eye (0.9%) developed culture-positive endophthalmitis.

Conclusions: Significant morbidity is associated with IVTA injection; clinicians should be aware when considering treatment options.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / adverse effects
  • Diabetic Retinopathy / complications
  • Diabetic Retinopathy / drug therapy
  • Diabetic Retinopathy / physiopathology
  • Endophthalmitis / chemically induced
  • Exfoliation Syndrome / complications
  • Exfoliation Syndrome / physiopathology
  • Eye Diseases / chemically induced*
  • Eye Diseases / physiopathology
  • Female
  • Glaucoma / complications
  • Glaucoma / physiopathology
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / adverse effects*
  • Humans
  • Injections / methods
  • Intraocular Pressure / drug effects
  • Macular Edema / complications
  • Macular Edema / drug therapy
  • Macular Edema / physiopathology
  • Male
  • Middle Aged
  • Retinal Detachment / chemically induced
  • Retinal Diseases / complications
  • Retinal Diseases / drug therapy*
  • Retinal Diseases / physiopathology
  • Retrospective Studies
  • Triamcinolone Acetonide / administration & dosage
  • Triamcinolone Acetonide / adverse effects*
  • Vitreous Body

Substances

  • Anti-Inflammatory Agents
  • Glucocorticoids
  • Triamcinolone Acetonide