Secondary ocular hypertension after intravitreal injection with 2 mg or 4 mg of triamcinolone in retinal vein occlusion

Abstract

Purpose: To evaluate secondary ocular hypertension after intravitreal injection of triamcinolone acetonide (IVTA) with 2 mg/0.05 mL or 4 mg/0.1 mL for macular edema associated with retinal vein occlusion (RVO).

Methods: A retrospective chart review was performed. Patients with RVO, including central RVO and branch RVO, were divided into 2 groups. Group 1 was patients who received 2 mg IVTA and group 2 received 4 mg IVTA. The dose of IVTA was dependent on individual surgeon's decision. Secondary ocular hypertension was defined as intraocular pressure (IOP) >21 mmHg. Long-term antiglaucoma medication referred to eyes that required antiglaucoma agents for >6 months.

Results: Thirty-six eyes in group 1 and 32 eyes in group 2 were included in the analyses. The mean age of all the patients was 58.6 years, and 52.9% of patients were men. The mean follow-up period was 12.4 months. A wide range (from day 7 to month 8) of time until the onset of the IOP spike was recorded after the injection. The incidence of secondary ocular hypertension was not significantly different between group 2 and group 1 (38.9% vs. 50%, P = 0.36). However, group 2 had a higher proportion of long-term antiglaucoma medication usage than group 1 (5.6% vs. 40.6%; Pearson chi-square, P < 0.001). Ultimately, 2.9% of patients underwent filtration surgery. Macular edema diminished and best-corrected visual acuity improved at 3 months later in both groups.

Conclusions: With a similar effect on vision recovery and alleviating macular edema associated with RVO, 2 mg IVTA required a shorter duration of medical control for secondary ocular hypertension than 4 mg IVTA.