Comparison of Intraocular Pressure Elevation After Anterior Versus Posterior Subtenon Triamcinolone Acetonide Acetate Injection

Liu, Xiao‐Ling; Li, Yingzi; Yin, Zhinan; Du, Wennan; Sun, Song Yung; Lin, Bing; Chen, Hao; Cheng, Lingyun

doi:10.1097/iae.0b013e31824fd384

Cited by 20 publications

(11 citation statements)

References 18 publications

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“…As in the present study, IOP elevation after treatment with 20 mg STTA was observed in 7/85 eyes (8.2%) [7] and 8/48 eyes (16.7%) [34]; IOP elevation after treatment with 40 mg STTA was observed in 6/49 eyes (12%) [41], 6/35 eyes (17%) [5], and 26/115 eyes (22.6%) [42].…”

Section: Discussionsupporting

confidence: 78%

Intraocular pressure elevation after subtenon triamcinolone acetonide injection; Multicentre retrospective cohort study in Japan

et al. 2019

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PurposeTo evaluate real-world evidence for intraocular pressure (IOP) elevation after subtenon triamcinolone acetonide injection (STTA) in 1252 Japanese patients (1406 eyes) in the Japan Clinical REtina STudy group (J-CREST).MethodsThis was a multicentre retrospective study of the medical records of 1252 patients (676 men (758 eyes); mean age: 63.8 ± 12.9 years) who received STTA in participating centres between April 2013 and July 2017.ResultsIOP elevation was observed in 206 eyes (14.7%) and IOP increase ≥ 6 mmHg was found in 328 eyes (23.3%). In total, 106 eyes (7.5%) needed medication and two eyes (0.14%) needed surgical procedures. Younger age, higher baseline IOP, and steroid dose were risk factors associated with IOP elevation. Risk factors associated with IOP increase ≥ 6 mmHg were younger age, lower baseline IOP, steroid dose, and higher incidences of diabetic macular oedema (DME) and uveitis. In contrast, with steroid dose fixed at 20 mg, a lower incidence of DME was a risk factor for increased IOP, suggesting that STTA had dose-dependent effects on IOP increase, especially in patients with DME.ConclusionOur real-world evidence from a large sample of Japanese patients who received STTA showed that the incidence of IOP elevation after STTA was 14.7%, and was associated with younger age, higher baseline IOP, and steroid dose. Thus, IOP should be monitored, especially in patients with younger age, higher baseline IOP, and higher incidences of DME and uveitis.

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Section: Discussionsupporting

confidence: 78%

Intraocular pressure elevation after subtenon triamcinolone acetonide injection; Multicentre retrospective cohort study in Japan

et al. 2019

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“…[ 8 9 10 20 ] Furthermore, PSTA showed 2.4 times lower risk of associated IOP elevation than anterior subtenon triamcinolone injection. [ 21 ] Therefore, we added PSTA on routine IVR for these refractory diabetic patients, in order to enhance the efficacy of macular edema control and lower the possibility of postinjection ocular hypertension.…”

Section: Discussionmentioning

confidence: 99%

Combined intravitreal ranibizumab and posterior subtenon triamcinolone acetonide injections for patients with diabetic macular edema refractory to intravitreal ranibizumab monotherapy

Chiu¹,

Huang²,

Chang³

et al. 2021

Taiwan Journal of Ophthalmology

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PURPOSE: The purpose of this study is to compare the efficacy of intravitreal ranibizumab (IVR) alone and concurrent IVR with posterior subtenon triamcinolone acetonide (PSTA) injection for patients with diabetic macular edema (DME) refractory to IVR monotherapy. MATERIALS AND METHODS: We enrolled 43 eyes of 43 patients with DME who received at least three times of IVR, which resulted in poor anatomical responses, with central foveal thickness (CFT) reduction <10% and postinjection CFT >300 μm. All the eyes received initial 3 monthly then pro re nata (PRN) IVR 0.5-mg injections. Twenty eyes continued PRN injections and 23 eyes received combined IVR 0.5 mg and PSTA 40 mg with at least 1-year follow-up. Best-corrected visual acuity (BCVA) and CFT were recorded from 1-month to 1-year follow-up. RESULTS: Following switch to combined therapy, the mean BCVA significantly improved from 0.61 ± 0.32 logarithm of the minimum angle of resolution (logMAR) to 0.45±0.39 logMAR at 6 month ( P = 0.003), 0.43±0.35 logMAR at 9 months ( P < 0.001), and 0.48±0.45 logMAR at 1 year ( P = 0.03). In eyes with IVR alone, no significant VA improvement was noted throughout the year. Significantly better BCVA was noted in the combined group at 6-month, 9-month, and 1-year follow-up compared to IVR-alone group. The timing of combined therapy showed a significant association with 1-year BCVA ( t = 3.25, P = 0.018). CONCLUSION: Concurrent IVR and PSTA resulted in significantly better visual outcomes in 1-year follow-up for those refractory to preceding ranibizumab monotherapy for DME. Early addition of PSTA predicted a better visual outcome.

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“…Previous literature reported that an anterior subtenon injection of TA was 2.4 times more likely (95% CI, 1.02-5.9) to cause elevated IOPs than a posterior subtenon injection 16 . A higher level of aqueous humor triamcinolone may be associated with a higher incidence of IOP elevation.…”

Section: Iopmentioning

confidence: 90%

Subconjunctival injections of triamcinolone acetonide to treat uveitic macular edema

Liu

Liang

et al. 2019

Preprint

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Background: To evaluate the efficacy and safety of subconjunctival triamcinolone acetonide (TA) injections for treating uveitic macular edema (UME). Methods: This retrospective case series study included patients with UME who received subconjunctival TA injections with a minimum follow-up period of 6 months. The main outcome was central macular thickness. The secondary outcomes included the best corrected visual acuity, recurrence rate and intraocular pressure. Results: In total, 68 patients (83 eyes) were enrolled in this study. The mean CMT decreased from 456.9 ± 171.1 μm at baseline to 324 ± 175.9 μm, 305.6 μm ± 147.7 μm, 331.8 ± 154.3 μm and 281.1 ± 147.6 μm at 1, 2, 3 and 6 months postinjection, respectively (all P < 0.01). A total of 21/83 eyes exhibited elevated IOPs, which was controlled with topical IOP-lowering agents in 14 eyes, whereas 7 eyes got subconjunctival TA deposit surgically removed. Conclusion: subconjunctival TA injections appear to be safe and effective for UME.Key Words: Triamcinolone acetonide; subconjunctival injection; uveitis; macular edema

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Comparison of Intraocular Pressure Elevation After Anterior Versus Posterior Subtenon Triamcinolone Acetonide Acetate Injection

Abstract: An ASTI of triamcinolone acetonide may bear a higher risk of developing elevated IOP than a PSTI of triamcinolone acetonide.

Cited by 20 publications

References 18 publications

Intraocular pressure elevation after subtenon triamcinolone acetonide injection; Multicentre retrospective cohort study in Japan

Intraocular pressure elevation after subtenon triamcinolone acetonide injection; Multicentre retrospective cohort study in Japan

Combined intravitreal ranibizumab and posterior subtenon triamcinolone acetonide injections for patients with diabetic macular edema refractory to intravitreal ranibizumab monotherapy

Subconjunctival injections of triamcinolone acetonide to treat uveitic macular edema

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