Ocular side effects associated with peribulbar injections of triamcinolone acetonide for diabetic macular edema

Emily Y. Chew, Adam R. Glassman, Roy W. Beck, Neil M Bressler, Gary E. Fish, Fredrick L. Ferris, James L. Kinyoun

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)284-289
Number of pages6
JournalRetina
Volume31
Issue number2
DOIs
StatePublished - Feb 2011

Fingerprint

Triamcinolone Acetonide
Macular Edema
Intraocular Pressure
Injections
Cataract
Lasers
Light Coagulation
Adrenal Cortex Hormones
Incidence

Keywords

  • diabetic macular edema
  • peribulbar injections
  • Triamcinolone acetonide

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Ocular side effects associated with peribulbar injections of triamcinolone acetonide for diabetic macular edema. / Chew, Emily Y.; Glassman, Adam R.; Beck, Roy W.; Bressler, Neil M; Fish, Gary E.; Ferris, Fredrick L.; Kinyoun, James L.

In: Retina, Vol. 31, No. 2, 02.2011, p. 284-289.

Research output: Contribution to journalArticle

Chew, Emily Y. ; Glassman, Adam R. ; Beck, Roy W. ; Bressler, Neil M ; Fish, Gary E. ; Ferris, Fredrick L. ; Kinyoun, James L. / Ocular side effects associated with peribulbar injections of triamcinolone acetonide for diabetic macular edema. In: Retina. 2011 ; Vol. 31, No. 2. pp. 284-289.
@article{a9495ba587e44e56a9a925b7be8f7c4e,
title = "Ocular side effects associated with peribulbar injections of triamcinolone acetonide for diabetic macular edema",
abstract = "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.",
keywords = "diabetic macular edema, peribulbar injections, Triamcinolone acetonide",
author = "Chew, {Emily Y.} and Glassman, {Adam R.} and Beck, {Roy W.} and Bressler, {Neil M} and Fish, {Gary E.} and Ferris, {Fredrick L.} and Kinyoun, {James L.}",
year = "2011",
month = "2",
doi = "10.1097/IAE.0b013e3181f049a8",
language = "English (US)",
volume = "31",
pages = "284--289",
journal = "Retina",
issn = "0275-004X",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

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 - diabetic macular edema

KW - peribulbar injections

KW - Triamcinolone acetonide

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

VL - 31

SP - 284

EP - 289

JO - Retina

JF - Retina

SN - 0275-004X

IS - 2

ER -