gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Variations in intraocular pressure (IOP) following intravitreal Triamcinolone injection

Meeting Abstract

Search Medline for

  • corresponding author M.C. Dwinger - University Eye Clinic, Bonn
  • N. Eter - University Eye Clinic, Bonn
  • I. Pieper - University Eye Clinic, Bonn
  • F.G. Holz - University Eye Clinic, Bonn

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogP 182

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dog2004/04dog673.shtml

Published: September 22, 2004

© 2004 Dwinger et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective

Intravitreal triamcinolone injection (IVT) has become a treatment option for macular edema of various etiologies and neovascular retinal diseases. Aside the possibility of a steroid-induced secondary open-angle glaucoma, the acute rise in intravitreal volume immediately after injection could induce an elevated IOP that might possibly lead to a central artery occlusion. To decrease the intravitreal volume a paracentesis with additional potential risks is performed by some. We determined variations in IOP at different time points immediately after IVT.

Methods

The IOP was recorded by applanation tonometry preoperatively, as well as 10 minutes, 1, 3 and 24 hours after intravitreal injection of 0.1ml (4mg) triamcinolone acetonide. So far 15 eyes of 14 patients with diabetic macular edema, diffuse edema after central vein occlusion and occult subfoveal choroidal neovascularization in age-related macular degeneration have been included in the study. Statistical analysis was performed using the Wilcoxon-test.

Results

Ten minutes postoperatively, IOP values were significantly higher (median 20mmHg, range 8-35mmHg, p<0.05) as compared to baseline, (16 mmHg, 12-21mmHg). Already 1 h after the injection the IOP values decreased significantly (16mmHg, 10-22mmHg, p<0.05). Three hours as well as 24h after injection the median IOP was not significantly different from preoperative values (15mmHg, 10-19mmHg). Directly after IVT, light perception was tested and retinal perfusion was evaluated by indirect ophthalmoscopy. In none of the patients a paracentesis was necessary.

Conclusions

The additional volume of 0.1ml triamcinolon acetonide in the vitreous led to a moderate transient rise in IOP. A routinely performed paracentesis immediately before or after IVT appears not necessary. After injection, testing of light perception or retinal perfusion appears nevertheless prudent to intervene if necessary.