Clinical Manifestations of Intraocular Pressure Elevation after Intravitreal Injection of Triamcinolone Acetonide

Purpose: To evaluate the incidence of intraocular pressure (IOP) elevation and the associated factors following intravitreal triamcinolone acetonide injection. Methods: A retrospective observational case study was performed in 143 eyes of 143 patients who received intravitreal injection of 4 mg triamcinlone acetonide and who had a minimum follow-up of 6 months. The eyes were examined before and periodically after the intravitreal injection of triamcinolone acetonide. A significant IOP elevation was defined as IOP>21 mmHg or a rise of more than 5 mmHg in patient with IOP over 21 mmHg at their first examination. Results: Mean IOP increased from 16.1±3.2 mmHg preoperatively to 23.3±7.7 mmHg postoperatively. A significant IOP elevation was observed in 68 eyes (47.6%). IOP elevation was observed the day after injection and decreased to the baseline value after 6 months following injection. The time to reach maximum IOP was 3 months in 24.5%, 2 months in 20.3% and 1 week in 12.6%. Factors associated with IOP elevation were younger age, high IOP before injection, myopia, and unaccompanying anterior chamber paracentesis. Most cases of IOP elevation following intravitreal triamcinolone acetonide injection were controlled by antiglaucoma medication. However, in 4 eyes, filtering surgery or valve implantation was required. Conclusions: IOP elevation after intravitreal triamcinolone injection is common and may take an extended period of time to manifest. Cautious monitoring of IOP is recommended after intravitreal triamcinolone injection especially in younger patients and those with high IOP before injection, myopia, and unaccompanying anterior chamber paracentesis.