The Effect of Intravitreal Triamcinolone Acetonide and Bevacizumab Injection on Intraocular Pressure

Jong-seo Park; Sung-Woo Ha; Seong-Bae Park

doi:10.3341/jkos.2010.51.11.1491

Journal List > J Korean Ophthalmol Soc > v.51(11) > 1008688

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Park, Ha, and Park: The Effect of Intravitreal Triamcinolone Acetonide and Bevacizumab Injection on Intraocular Pressure

Original Article

J Korean Ophthalmol Soc 2010;51(11):1491-1498.

Published online: 7 September 2010

DOI: https://doi.org/10.3341/jkos.2010.51.11.1491

The Effect of Intravitreal Triamcinolone Acetonide and Bevacizumab Injection on Intraocular Pressure

Jong-seo Park, MD, Sung-Woo Ha, MD, Seong-Bae Park, MD

Department of Ophthalmology, CHA University, CHA Bundang medical center, Seongnam, Korea

Address reprint requests to Seong-Bae Park, MD Department of Ophthalmology, Bundang CHA Medical Center # 351 Yatap-dong, Bundang-gu, Seongnam 463-712, Korea Tel: 82-31-780-5330, Fax: 82-31-780-5333, E-mail: ophth75@hanmail.net

Received 5 April 2010 Accepted 27 September 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare intraocular pressure (IOP) changes after intravitreal triamcinolone acetonide versus bevacizumab injection.

Methods

IOP was measured in 40 patients who received an intravitreal injection of 0.1 ml triamcinolone and 40 patients who received 2 consecutive intravitreal injections of bevacizumab (0.05 ml and 0.1 ml). Patients were divided into three groups: 0.1 ml triamcinolone group (0.1 IVTA group), 0.05 ml bevacizumab group (0.05 IVB group), and 0.1 ml bevacizumab group (0.1 IVB group). IOPs were compared within groups at different time points (before, 1 day after, and 30 days after the injection) and between groups at the same time points.

Results

In the 0.05 IVB and 0.1 IVB groups, IOP at 1 day after injection was significantly lower than before injection (P＜ 0.01, P = 0.03), and IOP at 30 days after injection was significantly higher than IOP at 1 day after injection (P < 0.01, P <0.01). In the 0.1 IVTA group, IOP at 30 days after injection was significantly higher than before injection (P = 0.01). Between groups, IOP at 1 day after injection in the 0.05 IVB group was significantly lower than IOP in the 0.1 IVTA group (P = 0.03).

Conclusions

IOP was decreased at 1 day after intravitreal bevacizumab injection, whereas in intravitreal triamcinolone acetonide IOP elevation persisted after 1 month.

Keywords: Bevacizumab, Intraocular pressure, Triamcinolone acetonide

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Figure 1.

Comparison of intraocular pressure between groups at the same time of injection. There was significant difference between groups at POD 1 day (ANOVA; P = 0.043).

^* Indicates a statistically significant difference between 0.05 IVB group and 0.1 IVTA group at POD 1 day (Post hoc test; P = 0.033).

Figure 2.

Comparison of intraocular pressure within groups at different time of injection. Symbols denote statistically significant difference between the two groups.

^* P＜ 0.001l; ^† P＜ 0.001l ^‡ P = 0.035; ^§ P = 0.008; ^∏ P = 0.01.

Table 1.

Demographic features

Factors	IVB group (n=40)	IVTA group (n=40)	P value
Sex			0.445
Male	24 (54.5%)	20 (50%)	
Female	16 (44.4%)	20 (50%)	
Age (year, mean ± SD)	59.32 ± 13.92	59.37 ± 10.46	0.986
IOP^* (mmHg)	14.62 ± 3.09	14.47 ± 2.88	0.823
Diabetes mellitus	11 (27.5%)	29 (72.5%)	< 0.001
Laterality			0.535
OD	20 (50%)	22 (55%)	
OS	20 (50%)	18 (45%)	
Diagnosis			< 0.001
AMD^†	17 (42.5%)	0 (0%)	
DMR^‡	9 (22.5%)	29 (72.5%)	
BRVO^§	12 (30.0%)	8 (20.0%)	
CRVO^∏	2 (5.0%)	3 (7.5%)	

^* IOP = intraocular pressure

^† AMD = age related macular degeneration

^‡ DMR = diabetic retinopathy

^§ BRVO = branch retinal vein occlusion

^∏ CRVO = central retinal vein occlusion.

Table 2.

Characteristics of patients with higher IOP-lowering response patients in IVB 0.05 ml group

Factors	Higher response patients (n=11)	Other patients (n=29)	P value
Sex			0.312
Male	8 (72.7%)	16 (55.2%)	
Female	3 (27.3%)	13 (44.8%)	
Age (year, mean ± SD)	63.09 ± 11.64	57.89 ± 14.62	0.254
IOP^* before injection	16.45 ± 3.07	13.93 ± 2.85	0.030^＃
IOP^* at POD 1 day	11.27 ± 2.19	13.51 ± 2.81	0.014^＃
IOP^* at POD 30 day	15.18 ± 2.40	14.48 ± 2.32	0.418
Diabetes mellitus	2 (18.2%)	9 (31.0%)	0.471
Laterality			0.288
OD	7 (63.6%)	13 (44.8%)	
OS	4 (36.4%)	16 (55.2%)	
Diagnosis			0.808
AMD^†	4 (36.4%)	13 (44.8%)	
DMR^‡	2 (18.2%)	7 (24.1%)	
BRVO^§	4 (36.4%)	8 (27.6%)	
CRVO^∏	1 (9.1%)	1 (3.4%)	

^* IOP = intraocular pressure

^† AMD = age related macular degeneration

^‡ DMR = diabetic retinopathy

^§ BRVO = branch retinal vein occlusion

^∏ CRVO = central retinal vein occlusion

^＃ indicates statistical significance.

Table 3.

Characteristics of patients with higher IOP-lowering response patients in IVB 0.1 ml group

Factors	Higher response patients (n = 9)	Other patients (n = 31)	P value
Sex			0.064
Male	8 (88.9%)	16 (48.4%)	
Female	1 (11.1%)	15 (51.6%)	
Age (year, mean ± SD)	57.77 ± 11.11	59.77 ± 14.77	0.667
IOP^* before injection	15.66 ± 1.93	14.38 ± 2.38	0.119
IOP^* at POD 1 day	11.22 ± 1.30	13.38 ± 2.96	0.041^＃
IOP^* at POD 30 day	14.00 ± 3.16	15.41 ± 3.54	0.268
Diabetes mellitus	2 (22.2%)	9 (29.0%)	0.687
Laterality			0.705
OD	5 (55.6%)	15 (48.4%)	
OS	4 (44.4%)	16 (51.6%)	
Diagnosis			0.159
AMD^†	2 (22.2%)	15 (48.4%)	
DMR^‡	1 (11.1%)	8 (25.8%)	
BRVO^§	5 (55.6%)	7 (22.6%)	
CRVO^∏	1 (11.1%)	1 (3.2%)	

^* IOP = intraocular pressure

^† AMD = age related macular degeneration

^‡ DMR = diabetic retinopathy

^§ BRVO = branch retinal vein occlusion

^∏ CRVO = central retinal vein occlusion

^＃ indicates statistical significance.

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