Frequency and management of raised intraocular pressure following intravitreal triamcinolone acetonide

Objective: To determine the frequency and management of intraocular pressure (IOP) elevation following intravitreal triamcinolone acetonide (IVTA). Study Design: Case series. Place and Duration of Study: Isra Postgraduate Institute of Ophthalmology/Al-Ibrahim Eye Hospital, Karachi, from May 2007 to May 2008. Methodology: In this study, 198 eyes of 150 patients requiring IVTA injection, were included. Pre-injection assessment comprised of detailed history, general and ocular examination including anterior and posterior segment examination with IOP measurements with Goldmann tonometer. After informed consent, IVTA 4 mg/0.1 ml was injected through pars plana and IOP was measured at 1 week, 1 month, 3 months and 6 months and if raised, treated accordingly. Results: Out of 150 patients, 82 were male (54.7%) and 68 were female (45.3%) (M: F = 1.2: 1). Mean age was 50.61 ± 10.59 years. Raised IOP value after IVTA, higher than 21 mmHg was observed at one week in 28 eyes (14.1%), at 1 month in 48 eyes (24.2%), at 3 months in 76 eyes (38.4%) and at 6 months in 25 eyes (12.6%). Raised IOP was controlled by topical beta blockers alone or in combination with carbonic anhydrase inhibitors in 58 eyes (76.3%). Conclusion: Elevation of IOP after IVTA injection occurred in 76 eyes (38.3%). It may take an extended period of time to manifest raised IOP. In majority of the patients, raised IOP was managed with topical medications.