Document Detail


Secondary ocular hypertension after intravitreal injection of 4 mg of triamcinolone acetonide: incidence and risk factors.
MedLine Citation:
PMID:  18398360     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To analyze the incidence of secondary ocular hypertension (SOH) after intravitreal triamcinolone acetonide (IVTA) injection and its risk predictors. METHODS: Retrospective review of charts for 219 consecutive patients receiving a 4-mg IVTA injection. RESULTS: One hundred fifty eyes of 150 patients who were followed for at least 3 months and met inclusion criteria were considered. Main indications for IVTA injection were neovascular age-related macular degeneration (79 eyes [52.7%]), choroidal neovascularization due to other etiologies (22 eyes [14.7%]), diabetic macular edema (14 eyes [9.3%]), central retinal vein occlusion (12 eyes [8.0%]), and branch retinal vein occlusion (8 eyes [5.3%]). SOH defined as intraocular pressure (IOP) of >or=21 mmHg was recorded for 32.0% of injected eyes at some point during a mean follow-up of 7.7 months. There was no association between SOH and age, sex, arterial hypertension, diabetes mellitus, indication for IVTA injection, prior cataract surgery, or concurrent photodynamic therapy. Although previous pars plana vitrectomy did not influence risk, peak IOP was lower in vitrectomized eyes (P = 0.044). Prior diagnosis of glaucoma was a significant risk factor for SOH (relative risk = 2.17; P = 0.004). In nonglaucomatous eyes, baseline IOP of >or=16 mmHg was associated with a higher risk of SOH (relative risk = 2.31; P = 0.003). Baseline IOPs of <12 mmHg, 12-14 mmHg, 15-17 mmHg, 18-20 mmHg, and >20 mmHg were associated with incidences of SOH of 11.1%, 25.4%, 40.0%, 46.2%, and 50.0% (P = 0.01), respectively. CONCLUSIONS: A 4-mg IVTA injection was associated with SOH in 32.0% of treated eyes. The risk of SOH was higher in eyes with previous glaucoma and higher baseline IOP. Peak IOP after IVTA injection was lower in vitrectomized eyes. Risk factor analysis may permit better individualization of the risk-benefit ratio for IVTA injection.
Authors:
Daniel V Vasconcelos-Santos; Patrícia G Nehemy; Andrew P Schachat; Márcio B Nehemy
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Retina (Philadelphia, Pa.)     Volume:  28     ISSN:  0275-004X     ISO Abbreviation:  Retina (Philadelphia, Pa.)     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-11     Completed Date:  2008-05-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309919     Medline TA:  Retina     Country:  United States    
Other Details:
Languages:  eng     Pagination:  573-80     Citation Subset:  IM    
Affiliation:
Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. dvitor@ufmg.br
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Choroidal Neovascularization / drug therapy
Female
Glucocorticoids / adverse effects*
Humans
Incidence
Injections
Intraocular Pressure / drug effects*
Macular Degeneration / drug therapy
Male
Middle Aged
Ocular Hypertension / chemically induced*
Retrospective Studies
Risk Factors
Tonometry, Ocular
Triamcinolone Acetonide / adverse effects*
Vitreous Body
Chemical
Reg. No./Substance:
0/Glucocorticoids; 76-25-5/Triamcinolone Acetonide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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