Intravitreal triamcinolone-induced elevated intraocular pressure is associated with the development of posterior subcapsular cataract

Gillies, Mark C; Kuzniarz, Maciek; Craig, Jamie E; Ball, Matthew; Luo, Wei; Simpson, Judy M.

doi:10.1016/j.ophtha.2004.07.017

Cited by 133 publications

(87 citation statements)

References 26 publications

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“…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%

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: 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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“…12 Intravitreal triamcinolone has also been associated with side effects such as raised IOP, cataract formation, and endophthalmitis. [13][14][15][16] The most commonly reported complication associated with IVTA injection is elevation of IOP. [17][18][19] The rate of this complication shows wide variation in published studies ranging from 20.8 to 52% of operated eyes.…”

Section: Discussionmentioning

confidence: 99%

Ocular morbidity associated with intravitreal triamcinolone acetonide

Konstantopoulos¹,

Williams²,

Newsom³

et al. 2006

Eye

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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 ¼ 41 eyes), retinal vein occlusions (n ¼ 27), postoperative cystoid macular oedema (n ¼ 24), exudative age-related macular degeneration (n ¼ 16), and others (n ¼ 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.

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“…Transient ocular hypertension and cataract are the most common complications occurring in 30 and 10% of patients, respectively. [1][2][3][4] Globe rupture to date has not to our knowledge been reported. …”

Section: Commentmentioning

confidence: 90%

“…Few reports have documented adverse events including intractable glaucoma, endophthalmitis, intraocular haemorrhage, and hypotony. [1][2][3][4] We report a case of scleral rupture as a complication of this procedure.…”

Section: Sir Globe Rupture As a Complication Of Intravitreal Injectimentioning

confidence: 97%

Globe rupture as a complication of intravitreal injection of triamcinolone

Ung

Williams

Canning

2006

Eye

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Intravitreal triamcinolone-induced elevated intraocular pressure is associated with the development of posterior subcapsular cataract

Cited by 133 publications

References 26 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

Ocular morbidity associated with intravitreal triamcinolone acetonide

Globe rupture as a complication of intravitreal injection of triamcinolone

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