Intraocular Pressure Changes in Eyes Receiving Intravitreal Triamcinolone Acetonide in Kikuyu Eye Unit

Abstract

Objective: To determine the magnitude and pattern of intraocular pressure (JOP) changesin eyes that received intravitreal triamcinolone acetonide in Kikuyu Eye Unit. Study Design: retrospective interventional case series. Setting: Kikuyu Eye Unit. Subjects: Seventy-two eyes (of 61 patients) injected between January 2007 and August2008. Methods: Data on lOP, indication for injection, additional procedures (cataract surgery,retinal photocoagulation), and treatment was collected using questionnairesand analysed using SPSS version 11.5. Results: The mean pre-injection lOP was 16.0 (SD 5.2) mmllg, which increased to 23.8 (SD 11.5) mmHg after intravitreal triamcinolone acetonide injection (p<O.OOI). lOP started increasing significantly within 2 weeks (p=0.006). The medianpost-injection time before lOP peak was 4.6 weeks, and lOP remained high for 24 weeks after injection. Intraocular pressure increase of 5 mmHg or more was foundin 39 (54.2%) eyes, while that of 10 mmlIg or more was found in 22 (30.1%).Increase of more than a third of pre-injection lOP was noted in 41 (56.9%) eyes.Thirty-three eyes (45.80/0)had maximum post-injection lOP beyond 21 nunllg. Twenty-two eyes (30.6%) received treatment for lOP elevation - mostly antiglaucomamedication - and one required cyclophotocoagulation. Eyes with pre-injectionrop of more than 21 mml-lg were associated with significantly higher lOP increases (p<O.OOI)and all received pressure-lowering medication. No associations were noticed between age, sex, other procedures, diagnosis and pattern ofIOP change. Conclusions: Intraocular increase was found to be a common complication of intravitreal triamcinolone acetonide, and the increase occurred mostly in the first 8 six months. Almost a third of eyes on treatment with lntravitreal triamcinolone acetonide received intervention for increased lOP. Recommendations: Close follow-up of eyes receiving lVTA is needed, and eyes with lOP over 21 mmlIg may benefit from prophylactic antiglaucoma medication immediately after lYTA.