Retina-Vitreous
2011 , Vol 19 , Num 2
Intraocular Pressure Changes after Different Types of Intravitreal Injections for the Treatment of Macular Edema
1Beyoğlu Göz Eğitim ve Araştırma Hastanesi, Göz Hastalıkları Kliniği, İstanbul, Uzm. Dr.2Van Erciş Devlet Hastanesi, Göz Hastalıkları Kliniği, Van, Uz. Dr.
3Gazipaşa Devlet Hastanesi, Göz Hastalıkları Kliniği, Antalya, Uzm. Dr.
4Beyoğlu Göz Eğitim ve Araştırma Hastanesi, Göz Hastalıkları Kliniği, İstanbul, Asist. Dr.
5Beyoğlu Göz Eğitim ve Araştırma Hastanesi, Göz Hastalıkları Kliniği, İstanbul, Doç. Dr.
6Beyoğlu Göz Eğitim ve Araştırma Hastanesi, Göz Hastalıkları Kliniği, İstanbul, Prof. Dr Purpose: To evaluate the effects of intravitreal triamcinolone acetonide (IVTA), bevacizumab (IVB), and the combination of IVTA/IVB on the intraocular pressure (IOP) change in a 6-month follow-up period.
Materials and Methods: Two hundred and seven eyes of 194 consecutive patients (113 male, mean age 61±10 years) that received an intravitreal injection between January 2007 and January 2008 for the treatment of macular edema were evaluated retrospectively. Group 1 consisted of 100 eyes of 94 patients treated with 4 mg IVTA injection, Group 2 consisted of 32 eyes of 27 patients treated with 1.25 mg IVB, and Group 3 consisted of 75 eyes of 73 patients treated with a combination of 2 mg TA and 1.25 mg bevacizumab. The primary outcome measures of the study were change in IOP and the number of eyes with elevated IOP requiring glaucoma treatment.
Results: The initial IOP was similar in all groups (p=0.413). However, in all follow-up examinations the difference between the groups was significant (p value for all visits <0.05). Treatment for elevated IOP was required in 21% eyes following IVTA injection and in 4% eyes following IVTA/IVB injection (p=0.001). None of the eyes that received IVB required glaucoma treatment. IOP rise was highest at one month following IVTA injection and at one week following IVTA/IVB injection.
Conclusion: A significant relation between the steroid dose and IOP elevation was found. Reduction of steroid dose resulted in less frequent IOP elevation. Keywords : Intraocular pressure, intravitreal bevacizumab, intravitreal injection, intravitreal triamcinolone acetonide