Kocabora M Selim, Yilmazli Cemil, Taskapili Muhittin, Gulkilik Gokhan, Durmaz Sahan
Vakif Gureba Education and Research Hospital, Istanbul, Turkey.
Clin Ophthalmol. 2008 Mar;2(1):167-71. doi: 10.2147/opth.s2359.
This study evaluates intraocular pressure (IOP) elevation secondary to intravitreal injection of triamcinolone acetonide (IVTA) and discusses its management.
The records of 175 patients who underwent IVTA treatment and regular eye examinations in the period 2003-2006 were reviewed. One hundred and twenty-two of these patients were included in the study, of which 147 eyes that received IVTA (4 mg/0.1 ml) were followed for at least 9 months. Mean IOPs observed after IVTA injection as well as IOP elevations defined as moderate (>/=5 mm Hg), important (>/=10 mm Hg) and severe (>25 mm Hg) during the follow-up period were evaluated and compared statistically.
Overall, the mean IOPs following IVTA injection were statistically significantly higher than the preinjection IOP (15.8 +/- 2.6), after the first hour (17.7 +/- 2.9), the first week (18.7 +/- 4.1), the first month (19.6 +/- 6.2), the second month (19.1 +/- 6.1), the third month (18.0 +/- 4.1), the sixth month (17.3 +/- 4.0), and the ninth month (17.0 +/- 2.7), but not after the first day (16.3 +/- 7.6). Important IOP elevations were observed mostly in the first (17.7%) and second months (10.2%). In 40 (27.7%) eyes, topical antiglaucomatous therapy was needed and 7 later required surgical intervention to lower the IOP. Of the remaining 33 eyes, topical treatment was continued in 14 (9.5%) because of IOPs >/=20 mm Hg.
The persistence of IOP elevation beyond the IVTA clearance period and the development of intractable secondary glaucoma requiring surgical intervention substantiate the need for careful consideration of IVTA indication and follow-up.
本研究评估玻璃体内注射曲安奈德（IVTA）继发的眼压（IOP）升高情况，并探讨其处理方法。
回顾了2003年至2006年期间接受IVTA治疗并定期进行眼部检查的175例患者的记录。其中122例患者纳入研究，对接受IVTA（4mg/0.1ml）的147只眼进行了至少9个月的随访。评估并统计比较了IVTA注射后观察到的平均眼压以及随访期间定义为中度（≥5mmHg）、重度（≥10mmHg）和极重度（>25mmHg）的眼压升高情况。
总体而言，IVTA注射后的平均眼压在统计学上显著高于注射前眼压（15.8±2.6），在注射后第1小时（17.7±2.9）、第1周（18.7±4.1）、第1个月（19.6±6.2）、第2个月（19.1±6.1）、第3个月（18.0±4.1）、第6个月（17.3±4.0）和第9个月（17.0±2.7）时均升高，但在第1天（16.3±7.6）后未升高。重度眼压升高主要出现在第1个月（17.7%）和第2个月（10.2%）。40只眼（27.7%）需要局部抗青光眼治疗，7只眼后来需要手术干预以降低眼压。其余33只眼中，14只眼（9.5%）因眼压≥20mmHg而继续进行局部治疗。
IVTA清除期后眼压持续升高以及发展为难治性继发性青光眼需要手术干预，这证实了仔细考虑IVTA适应证和随访的必要性。
