Intraocular Pressure Elevation After Intravitreal Triamcinolone Acetonide Injection in a Chinese Population

Lau, Ling Ing; Chen, Kuan Chieh; Lee, Fenq Lih; Chen, Shih‐Jen; Ko, Yu Chieh; Liu, Catherine Jui-Ling; Hsu, Wen Ming

doi:10.1016/j.ajo.2008.05.034

Cited by 29 publications

(17 citation statements)

References 21 publications

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“…The side effects in terms of an elevation in intraocular pressure were present in the triamcinolone group only, in a similar frequency and amount as already reported for Caucasians and in another study on Chinese patients. [21][22][23][24][25] The finding of a discrepancy between a recurrence of macular oedema and continuously improved visual acuity agrees with an observation by Kriechbaum et al, 32 in which 3 months after the injection macular oedema recurred and visual acuity remained unchanged.…”

Section: Discussionsupporting

confidence: 89%

“…6,7,[9][10][11][12][13][14][15][16][17][18][19] The two major side effects of the intravitreal triamcinolone were a steroid induced increase in intraocular pressure and development of cataract. [21][22][23][24][25] In contrast, studies on intravitreal bevacizumab by Rosenfeld et al and other researchers showed an improvement in visual acuity, reduction in macular thickness, and only minor complications in patients with CRVOs, [26][27][28][29][30][31][32][33][34] so that intravitreal triamcinolone was rapidly exchanged by intravitreal bevacizumab for the treatment of CRVO. It agrees with this study, in which the best-corrected visual acuity improved significantly in the triamcinolone group and in the bevacizumab group with a no statistically significant difference in the gain in visual acuity between both study groups, although the reduction in macular oedema was slightly more pronounced in the triamcinolone group (Table 2) (Figure 1).…”

Section: Discussionmentioning

confidence: 99%

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Intravitreal bevacizumab vs triamcinolone acetonide for macular oedema due to central retinal vein occlusion

Tao

Hou

et al. 2009

Eye

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Purpose To compare the effect of intravitreal bevacizumab vs intravitreal triamcinolone for the treatment of non-ischaemic central retinal vein occlusion (CRVO). Methods The comparative nonrandomized retrospective clinical interventional study included 72 patients with non-ischaemic CRVO, divided into a bevacizumab group of 30 patients (1.25 mg bevacizumab) and a triamcinolone group of 42 patients (4.0 mg triamcinolone). All patients were consecutively included. At baseline, both study groups did not vary significantly in visual acuity, macular thickness, and duration of symptoms (191 ± 300 days vs 222 ± 256 days). The minimal follow-up was 3 months (mean: 7.8 ± 4.3 months; range: 3-12 months). During follow-up, 1.3 ± 0.4 reinjections of the triamcinolone group (range: 1-2 injections) and 2.7±1.8 re-injections of bevacizumab (range:1-6 injections) were administered. Results In both study groups, the mean visual acuity increased significantly (Po0.001) from baseline during follow-up. The differences in gain in visual acuity were not statistically significant (P40.40) between both study groups at any time during follow-up. The mean macular thickness decreased significantly (Po0.001) in both study groups, with the reduction being significantly (P ¼ 0.006) more pronounced in the triamcinolone group. Intraocular pressure increased significantly (Po0.001) in the triamcinolone group. ConclusionsIn long-standing non-ischaemic CRVO, intravitreal bevacizumab and intravitreal triamcinolone are both associated with a comparable gain in visual acuity. The reduction in macular oedema was more marked in the triamcinolone group. In view of the potential complications of intravitreal triamcinolone in terms of intraocular pressure rise and cataractogenesis, bevacizumab may be preferred compared with triamcinolone for intravitreal use in non-ischaemic CRVO. Retinal vein occlusions belong to the most common retinal disorders affecting the macula and reducing central visual acuity. [1][2][3] In a recent populationbased study, retinal vein occlusions were detected in about 0.7% of eyes of adult Chinese aged 40 þ years. Branch retinal vein occlusions were about 12 times more common than central retinal vein occlusions (CRVOs), and the non-ischaemic type was about 9 times more common than the ischaemic type. From a pathogenic point of view, a decreased tissue perfusion and an increased hydrostatic pressure within the involved segments as a consequence of the vascular obstruction may lead to intraretinal haemorrhages, exudation of fluid, varying levels of tissue ischaemia, and eventually to intraocular neovascularization, if retinal ischaemia is pronounced. 4 Although the Central Vein Occlusion Study Group has shown the beneficial of panretinal

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Intravitreal bevacizumab vs triamcinolone acetonide for macular oedema due to central retinal vein occlusion

Tao

Hou

et al. 2009

Eye

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“…14,17,31 Lau ve ark. 21 ise 55 yaş altında İVTA uygulanan hastaların GİB artışı açısından daha riskli olduklarını bildirmişlerdir. Bu farklılığın sebeplerinden biri çalışmalardaki hastaların yaş dağılımlarındaki değişkenlik olabilir.…”

Section: Discussionunclassified

“…Çalışmaların çoğunda GİB artışı açısından cinsiyetler arasında fark bulunmazken 12,14,18,20,22,25,30 Sönmez, 17 Lau, 21 Rhee, 22 Breusegem ve ark. 32 çalışmalarında erkekleri GİB artışı açısından daha riskli bulmuşlardır.…”

Section: Discussionunclassified

“…11,12 İVTA enjeksiyonu ile geçici fakat etkili miktarda kortikosteroid göz içi dokulara geçmekte ve bu insanların %13-54'ünde GİB artışına neden olabilmektedir. 12,13,14,15,16,17,18,19,20,21,22,23,24,25 Ancak kimde GİB yüksekliği oluşacağını önceden bilmek zordur. İVTA enjeksiyonu sonrası GİB yüksekliği 8 aya kadar sürebilmektedir.…”

Section: Introductionunclassified

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Evaulation of Incidence and Risk Factors for Intraocular Pressure Elevation After Intravitreal Triamcinolone Acetonide Injection

Uçar¹,

Dikkaya²,

Arvas³

et al. 2015

tjo

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Amaç: Makula ödemi tedavisinde kullanılan intravitreal triamsinolon asetonidin göz içi basıncı (GİB) üzerine etkisini ve GİB artışı açısından risk faktörlerini araştırmaktır. Ge reç ve Yön tem: Bu retrospektif çalışmada 56'sı (%65,8) diyabetik retinopati, 7'si (%8,2) santral retinal ven ve 22'si (%25,8) retinal ven dal tıkanıklığı ilişkili makula ödemi nedeniyle 4 mg intravitreal triamsinolon uygulanan 85 hastanın 93 gözü değerlendirildi. Hastalar enjeksiyon sonrası GİB değişimleri, GİB artışı ile yaş, cinsiyet, lens durumu, makula ödem etiyolojisi ve başlangıç GİB değeri arasındaki ilişki açısından incelendi. Bulgular: Otuz dokuzu kadın 46'sı erkek olan hastaların yaş ortalaması 61,58±9,5 yıl idi. İzlem boyunca 30 gözde (%32,2) ortalama 7,5 haftada 24 mmHg'nin üzerine çıkan GİB artışı görüldü. GİB artışı görülen hastaların tamamı topikal antiglokomatöz ilaç ile kontrol altına alınabildi. Ven tıkanıklığı olan 29 gözün 15'inde (%51,7), diyabetik makula ödemi olan 64 gözün 15'inde (%23,3) GİB artışı görüldü (p=0,01). Fakik 73 gözün 26'sında (%35,6), psödofakik 20 gözün 4'ünde (%20) GİB 24 mmHg'nin üzerinde ölçüldü (p=0,16). GİB artışı ile cinsiyet arasında anlamlı ilişki bulunmadı (p=0,33). GİB'de artış saptanan gözlerin enjeksiyon öncesi GİB ortalamaları 16,47±2,8 mmHg iken, artış saptanmayanlarınki 14,78±2,4 mmHg idi. GİB artışı gelişimi ile başlangıç GİB değeri arasında anlamlı ilişki vardı (p=0,01). Sonuç: GİB artışı intravitreal triamsinolon enjeksiyonu sonrasında sık görülen bir yan etkidir fakat çoğunlukla topikal tedavi ile kontrol altına alınabilmektedir. Özellikle başlangıç GİB>15 mmHg olan ve ven oklüzyonu nedeniyle enjeksiyon uygulanan hastalar GİB artışı açısından daha fazla risk taşımaktadır. (Turk J Ophthalmol 2015; 45: 86-91) Anah tar Ke li me ler: Glokom, intravitreal steroid enjeksiyonu, intraoküler basınç, risk faktörleri Objectives: To investigate the effect of intravitreal triamcinolone acetonide (IVTA) used for the macular edema on intraocular pressure (IOP) and to determine the risk factors for IOP elevation. Ma te ri als and Met hods: This retrospective study included 93 eyes of 85 patients who had 4 mg intravitreal triamcinolone injection. Of the 85 patients, 56 (65.8%) had diabetic macular edema, 22 (25.8%) had branch retinal, and 7 (8.2%) had central retinal vein occlusion. IOP changes after injection as well as the relation between IOP elevation and age, sex, lens status, etiology of macular edema, baseline IOP were evaluated. Re sults: Fourty-six male and 39 female patients with mean age 61.58±9.5 years were evaluated. IOP was recorded to be >24 mmHg in 30 eyes (32.2%) at follow-up visit after an average of 7.5 weeks. Normalization of IOP with medication was achieved in all IOP elevated eyes. Fifteen of 29 eyes (51.7%) with vein occlusion and 15 of 64 eyes (23.3%) with diabetic macula edema had IOP elevation (p=0.01). Twenty-six of 73 phakic (35.6%) and 4 of 20 pseudophakic eyes (20%) had IOP >24 mmHg (p=0.16). There was no association between IOP elevation and sex (p=0.33). Baseline...

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Risk Factors Associated With Intraocular Pressure Increase in Patients With Uveitis Treated With the Fluocinolone Acetonide Implant

Parekh

Srivastava

Bena³

et al. 2015

JAMA Ophthalmol

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IMPORTANCE Elevated intraocular pressure (IOP) is a well-known adverse event associated with the fluocinolone acetonide implant (FAI), but no data are available regarding factors associated with increased risk of IOP elevation in patients treated with the FAI.OBJECTIVE To report risk factors that may predispose patients to elevated IOP after treatment with the FAI. DESIGN, SETTING, AND PARTICIPANTS Data from 3 multicenter, 3-year, prospective, randomized, phase 2b/3 clinical trials evaluating the safety and efficacy of the FAI were pooled and analyzed. Patients had no underlying glaucoma and at least one eye with a history of recurrent noninfectious uveitis affecting the posterior segment. Patients were treated with 1 or more of the following: systemic therapy (corticosteroids or other immunosuppressive drugs) for at least 3 months before enrollment, 2 or more sub-Tenon capsule corticosteroid injections for uveitis management during the 6 months before enrollment, or systemic corticosteroid or sub-Tenon capsule corticosteroid injection therapy required for at least 2 separate recurrences within 6 months before enrollment. MAIN OUTCOMES AND MEASURESFactors evaluated as risk factors for IOP elevation included age, sex, lens status, uveitis severity at enrollment, and location of uveitis.RESULTS Data analyses were based on 641 eyes. A total of 351 eyes did not receive the FAI, whereas 290 eyes had the 0.59-mg FAI placed. An increase in IOP of 10 mm Hg or elevation to 30 mm Hg was seen in 60 untreated eyes (17.1%) and 188 treated eyes (65.1%) (hazard ratio, 5.80; 95% CI, 4.28-7.70; P < .001). A total of 8 untreated eyes (2.3%) required surgical intervention for elevated IOP compared with 93 treated eyes (32.1%) (hazard ratio, 16.48; 95% CI, 8.24-32.96; P < .001). In patients with the FAI, younger age, male sex, and phakic lens status were associated with higher risk of IOP elevation and the need for glaucoma surgery (P = .003, P < .001, and P < .001, respectively). CONCLUSIONS AND RELEVANCEPatients receiving the FAI are at higher risk of developing an IOP increase of 10 mm Hg or an absolute IOP of 30 mm Hg when compared with patients without the FAI. Patients who are male, younger, and phakic are at an even higher risk for elevated IOP and possibly glaucoma surgery.

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Intraocular Pressure Elevation After Intravitreal Triamcinolone Acetonide Injection in a Chinese Population

Cited by 29 publications

References 21 publications

Intravitreal bevacizumab vs triamcinolone acetonide for macular oedema due to central retinal vein occlusion

Intravitreal bevacizumab vs triamcinolone acetonide for macular oedema due to central retinal vein occlusion

Evaulation of Incidence and Risk Factors for Intraocular Pressure Elevation After Intravitreal Triamcinolone Acetonide Injection

Risk Factors Associated With Intraocular Pressure Increase in Patients With Uveitis Treated With the Fluocinolone Acetonide Implant

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