Intraocular Pressure Changes in Eyes Receiving Intravitreal Triamcinolone Acetonide in Kikuyu Eye Unit
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Date
2009Author
Mpekethu, Mingaine
Type
ThesisLanguage
enMetadata
Show full item recordAbstract
Objective: To determine the magnitude and pattern of intraocular pressure (JOP)
changesin eyes that received intravitreal triamcinolone acetonide in Kikuyu Eye
Unit.
Study Design: retrospective interventional case series.
Setting: Kikuyu Eye Unit.
Subjects: Seventy-two eyes (of 61 patients) injected between January 2007 and
August2008.
Methods: Data on lOP, indication for injection, additional procedures (cataract
surgery,retinal photocoagulation), and treatment was collected using
questionnairesand analysed using SPSS version 11.5.
Results: The mean pre-injection lOP was 16.0 (SD 5.2) mmllg, which increased to
23.8 (SD 11.5) mmHg after intravitreal triamcinolone acetonide injection
(p<O.OOI). lOP started increasing significantly within 2 weeks (p=0.006). The
medianpost-injection time before lOP peak was 4.6 weeks, and lOP remained high
for 24 weeks after injection. Intraocular pressure increase of 5 mmHg or more was
foundin 39 (54.2%) eyes, while that of 10 mmlIg or more was found in 22
(30.1%).Increase of more than a third of pre-injection lOP was noted in 41 (56.9%)
eyes.Thirty-three eyes (45.80/0)had maximum post-injection lOP beyond 21
nunllg. Twenty-two eyes (30.6%) received treatment for lOP elevation - mostly
antiglaucomamedication - and one required cyclophotocoagulation. Eyes with
pre-injectionrop of more than 21 mml-lg were associated with significantly higher
lOP increases (p<O.OOI)and all received pressure-lowering medication. No
associations were noticed between age, sex, other procedures, diagnosis and
pattern ofIOP change.
Conclusions: Intraocular increase was found to be a common complication of
intravitreal triamcinolone acetonide, and the increase occurred mostly in the first
8
six months. Almost a third of eyes on treatment with lntravitreal triamcinolone
acetonide received intervention for increased lOP.
Recommendations: Close follow-up of eyes receiving lVTA is needed, and eyes
with lOP over 21 mmlIg may benefit from prophylactic antiglaucoma medication
immediately after lYTA.
Citation
Master of Medicine in OphthalmologyPublisher
University Of Nairobi College of Health Sciences