Drug reflux during posterior subtenon infusion of triamcinolone acetonide in diffuse diabetic macular edema not only brings insufficient reduction but also causes elevation of intraocular pressure

Abstract

At the time of STI-TA in DME, drug reflux of TA is a risk factor not only for insufficient reduction of edema, but also for postoperative IOP elevation.

Ocular Side Effects Associated With Peribulbar Injections of Triamcinolone Acetonide for Diabetic Macular Edema

“…15 Although not evaluated in this study, drug reflux following posterior subtenon injection has been demonstrated in another study to predict an increase in intraocular pressure. 16 …”

Reduction in the frequency of intravitreal bevacizumab administrations achieved by posterior subtenon injection of triamcinolone acetonide in patients with diffuse diabetic macular edema

“…In past studies of combination therapy of bevacizumab and triamcinolone acetonide, both drugs were administered by vitreous injection, which requires a bigger liquid volume (twice as much as that for single-drug therapy) and induces IOP elevation. In contrast, in our study, triamcinolone acetonide was administered through the subtenon space, which prevents cataract formation and IOP elevation if injected appropriately [14,22]. Thus, STTA/IVB combination therapy, which is different from IVTA/IVB therapy, might show better, safer, and longer-lasting results than IVB monotherapy for suppression of DME.…”

“…Before the administration of the drugs, the IOP was 15.6 ± 2.3 (range 11-20) mmHg in the STTA-treated eyes and 15.7 ± 2.8 (range [11][12][13][14][15][16][17][18][19][20] mmHg in the control eyes, and there was no significant difference between them (P = 0.927). After the initial IVB injection, the IOP in the STTA-treated eyes increased steeply and, after 24 weeks, significantly increased, while the IOP in the control eyes b Reduction ratio (refer to the text) in eyes with (black bar) and without (white bar) STTA.…”

“…Posterior subtenon injection of triamcinolone acetonide (STTA) is also effective for reducing DDME [12][13][14]. Apart from intravitreal injection of triamcinolone acetonide (IVTA), the adverse effects of increased IOP or progression of cataracts were hardly observed if applied appropriately [14].…”

“…Apart from intravitreal injection of triamcinolone acetonide (IVTA), the adverse effects of increased IOP or progression of cataracts were hardly observed if applied appropriately [14].…”