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Kang and Chin: Complications after Intravitreal Triamcinolone Acetonide Injection: Incidence and Risk Factors
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(1): 76-86.

Published online: 16 January 2012

DOI: https://doi.org/10.3341/jkos.2012.53.1.76

Complications after Intravitreal Triamcinolone Acetonide Injection: Incidence and Risk Factors

Haeng Ku Kang, MD, Hee Seung Chin, MD, PhD

Department of Ophthalmology, Inha University School of Medicine, Incheon, Korea.

Address reprint requests to Hee Seung Chin, MD, PhD. Department of Ophthalmology, Inha University Hospital, #7-206 Sinheung-dong 3-ga, Jung-gu, Incheon 400-711, Korea. Tel: 82-32-890-2408, Fax: 82-32-890-2403, hschin@inha.ac.kr

Received 6 April 2011       Accepted 28 October 2011

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To reduce complications and provide proper management for better clinical outcomes in the treatment of macular edema through a large-scale analysis of the incidence and risk factors for complications of intravitreal triamcinolone injection.

Methods

The medical records of 490 eyes that received intravitreal triamcinolone (4.0 mg) injection for treatment of macular edema caused by various diseases were retrospectively reviewed, and relevant parameters were included in a multivariate regression model.

Results

Vitrectomized (p < 0.001) and pseudophakic (p = 0.054) eyes were less likely to exhibit an intraocular pressure increase, but glaucoma (p < 0.001) and young age (p = 0.073) were found to be significant risk factors for this complication. Vitrectomized eyes (p = 0.011), diabetic macular edema (p < 0.001), secondary ocular hypertension (p = 0.029) and old age (p = 0.059) were associated with cataract progression. Three consecutive case of sterile endophthalmitis, which differs from bacterial endophthalmitis in clinical course and prognosis, occurred during the same period.

Conclusions

Risk factors and the incidence of complications after intravitreal triamcinolone injection should be evaluated through regular follow-up evaluation to ensure proper management and a better prognosis.

Keywords: Cataract progression, Complication, Intravitreal triamcinolone acetonide, Secondary ocular hypertension, Sterile endophthalmitis

Figures and Tables

Figure 1
The comparison of intraocular pressure and patient proportion of ocular hypertension according to intravitreal triamcinolone injections.
jkos-53-76-g001
Figure 2
The relationship of mean increased intraocular pressure and age distributions.
jkos-53-76-g002
Figure 3
The association of intraocular pressure increasing level and need cataract surgery.
jkos-53-76-g003
Table 1
General characteristics
jkos-53-76-i001

DMR = diabetic retinopathy; BRVO = branch retinal vein occlusion; CRVO = central retinal vein occlusion; AMD = age-related macular degeneration; IOP = intraocular pressure; SD = standard deviation.

Table 2
Complications after intravitreal triamcinolone injection
jkos-53-76-i002

IOP = intraocular pressure.

Table 3
Incidence and risk evaluation of secondary ocular hypertension after intravitreal trimacinolone acetonide injection according to basic characteristics
jkos-53-76-i003
Table 4
Comparison of intraocular pressure increase by diagnosis and degree of increased Intraocular pressure
jkos-53-76-i004

IOP = intraocular pressure; DMR = diabetic retinopathy; RVO = retinal vein occlusion; AMD = age-related macular degeneration.

Table 5
Patterns of intraocular pressure change in patients with secondary ocular hypertension after intravitreal triamcinolone injection
jkos-53-76-i005

IOP = intraocular pressure; DMR = diabetic retinopathy; RVO = retinal vein occlusion; AMD = age-related macular degeneration.

*Highest intraocular pressure during follow up period; †Maximum IOP - pre-injection IOP.

Table 6
The pattern of intraocular pressure change in patients needed medical treatment for control of intraocular pressure after Intravitreal triamcinolone injection
jkos-53-76-i006

IOP = intraocular pressure; DMR = diabetic retinopathy; RVO = retinal vein occlusion; AMD = age-related macular degeneration.

*Highest intraocular pressure during follow up period; †Maximum IOP - pre-injection IOP.

Table 7
Incidence and risk evaluation of cataract progression after intravitreal trimacinolone acetonide injection according to basic characteristics
jkos-53-76-i007
Table 8
Demographics and clinical findings of patients with non-infectious endophthalmitis
jkos-53-76-i008

DME = diabetic macular edema; BRVO = branch retinal vein occlusion; CME = cystoids macular edema; DM = diabetes mellutus; HTN = hypertension; AC = anterior chamber; BCVA = best corrected visual acuity.

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