TY - JOUR
T1 - Ocular side effects associated with peribulbar injections of triamcinolone acetonide for diabetic macular edema
AU - Chew, Emily Y.
AU - Glassman, Adam R.
AU - Beck, Roy W.
AU - Bressler, Neil M.
AU - Fish, Gary E.
AU - Ferris, Fredrick L.
AU - Kinyoun, James L.
PY - 2011/2
Y1 - 2011/2
N2 - Purpose: To evaluate long-term effects of anterior and posterior peribulbar injections of triamcinolone acetonide on intraocular pressure (IOP) elevation and cataract development. Methods: This study reports on IOP and cataract progression through 2 years in 96 eyes with diabetic macular edema randomized to focal/grid photocoagulation, 20 mg triamcinolone acetonide anterior injection, anterior injection followed by laser, 40 mg triamcinolone acetonide posterior injection, or posterior injection followed by laser. Results: Intraocular pressure increased from baseline by ≥10 mmHg at ≥1 visit through 2 years in 2 eyes (8%) in the laser group, 11 eyes (31%) in the anterior groups, and 6 eyes (17%) in the posterior groups. Among phakic eyes at baseline, 0, 5 (17%), and 1 (3%) in the 3 groups, respectively, underwent cataract surgery before the 2-year visit. Conclusion: Based on this small randomized trial, it appears that over 2 years, anterior peribulbar triamcinolone acetonide injections are associated with an increased incidence of IOP elevation and an increased risk of cataract development compared with laser or posterior peribulbar injections. The association of posterior injections with IOP elevation is less certain. Although the study involved eyes with diabetic macular edema, the results should be relevant to other conditions treated with peribulbar corticosteroids.
AB - Purpose: To evaluate long-term effects of anterior and posterior peribulbar injections of triamcinolone acetonide on intraocular pressure (IOP) elevation and cataract development. Methods: This study reports on IOP and cataract progression through 2 years in 96 eyes with diabetic macular edema randomized to focal/grid photocoagulation, 20 mg triamcinolone acetonide anterior injection, anterior injection followed by laser, 40 mg triamcinolone acetonide posterior injection, or posterior injection followed by laser. Results: Intraocular pressure increased from baseline by ≥10 mmHg at ≥1 visit through 2 years in 2 eyes (8%) in the laser group, 11 eyes (31%) in the anterior groups, and 6 eyes (17%) in the posterior groups. Among phakic eyes at baseline, 0, 5 (17%), and 1 (3%) in the 3 groups, respectively, underwent cataract surgery before the 2-year visit. Conclusion: Based on this small randomized trial, it appears that over 2 years, anterior peribulbar triamcinolone acetonide injections are associated with an increased incidence of IOP elevation and an increased risk of cataract development compared with laser or posterior peribulbar injections. The association of posterior injections with IOP elevation is less certain. Although the study involved eyes with diabetic macular edema, the results should be relevant to other conditions treated with peribulbar corticosteroids.
KW - Triamcinolone acetonide
KW - diabetic macular edema
KW - peribulbar injections
UR - http://www.scopus.com/inward/record.url?scp=79551540849&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79551540849&partnerID=8YFLogxK
U2 - 10.1097/IAE.0b013e3181f049a8
DO - 10.1097/IAE.0b013e3181f049a8
M3 - Article
C2 - 20948459
AN - SCOPUS:79551540849
SN - 0275-004X
VL - 31
SP - 284
EP - 289
JO - Retina
JF - Retina
IS - 2
ER -