Intraocular Pressure Following Intravitreal Injection of Triamcinolone Acetonide

Background: To investigate the intraocular pressure (IOP) response following intravitreal injection of triamcinolone acetonide. Methods: This retrospective consecutive non-comparative case series study included 41 patients (52 eyes) (19 male, 22 female, mean age 64.1 +/- 13.44; range 22-85 years) with progressive exudative ARMD (n = 10 eyes) or diffuse diabetic macular oedema (42 eyes), who received one or more intravitreal injection(s) of 4 mg triamcinolone acetonide. Results: IOP increased significantly (p<0.001) from 16.08 (+/- 3.28) mm Hg (range 12-26 mm Hg) preoperatively to a mean maximum of 26.1 (+/- 11.79) mmHg (range 15-80 mm Hg) postoperatively (p<0.001). An IOP rise to values higher than 21 mm Hg was observed in 28 (53.8%) eyes. Elevation of IOP occurred 7.5 weeks (+/- 7.07) after the injection. All five patients (11.9%) with a family history of glaucoma developed an IOP rise above the mean maximum level. The postinjection rise of IOP was statistically independent of gender (p=0.37), but the presence of diabetes mellitus demonstrated a marked influence on the rate of a postoperative elevation of IOP (p=0.05). Conclusion: The IOP response following IVTA was consistent with previous studies. A family history of glaucoma and a history of diabetes mellitus may predispose patients to a greater than average IOP rise following IVTA. Careful IOP assessment for at least 6 months post injection is recommended.