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 n 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.