Evaulation of Incidence and Risk Factors for Intraocular Pressure Elevation After Intravitreal Triamcinolone Acetonide Injection

Objectives: To investigate the effect of intravitreal triamcinolone acetonide (IVTA) used for the macular edema on intraocular pressure (IOP) and to determine the risk factors for IOP elevation. Materials and Methods: This retrospective study included 93 eyes of 85 patients who had 4 mg intravitreal triamcinolone injection. Of the 85 patients, 56 (65.8%) had diabetic macular edema, 22 (25.8%) had branch retinal, and 7 (8.2%) had central retinal vein occlusion. IOP changes after injection as well as the relation between IOP elevation and age, sex, lens status, etiology of macular edema, baseline IOP were evaluated. Results: Fourty-six male and 39 female patients with mean age 61.58 +/- 9.5 years were evaluated. IOP was recorded to be > 24 mmHg in 30 eyes (32.2%) at follow-up visit after an average of 7.5 weeks. Normalization of IOP with medication was achieved in all IOP elevated eyes. Fifteen of 29 eyes (51.7%) with vein occlusion and 15 of 64 eyes (23.3%) with diabetic macula edema had IOP elevation (p=0.01). Twenty-six of 73 phakic (35.6%) and 4 of 20 pseudophakic eyes (20%) had IOP > 24 mmHg (p=0.16). There was no association between IOP elevation and sex (p=0.33). Baseline IOP was 16.47 +/- 2.8 mmHg in eyes which had elevated IOP and 14.78 +/- 2.4 mmHg in the remaining. There was significant relation between IOP elevation and baseline IOP level (p=0.01). Conclusion: Elevated IOP is common side effect after IVTA, but normalization is usually achieved by topical medication. Patients with baseline IOP=15 mmHg and vein occlusion have higher risk for IOP elevation.