Preserved triamcinolone linked to higher rate of noninfectious endophthalmitis

Intravitreal injections of preservative-containing triamcinolone acetonide may increase the risk of developing noninfectious endophthalmitis compared with preservative-free injections of the drug, according to a study by researchers in Brazil.

Mauricio Maia, MD, and colleagues at Vision Institute in São Paulo reviewed outcomes for 471 eyes treated with 4 mg/0.1 mL injections of triamcinolone. Of 646 total injections performed, 69 contained preservative and 577 were preservative-free, according to the study.

The patients were examined at 1, 7 and 28 days and at 3, 4, 6 and 12 months post-injection and annually thereafter. Follow-up averaged 13 months and ranged from 6 months to 57 months.

Ocular hypertension, which was defined as an IOP greater than 23 mm Hg, occurred in 127 eyes (20%), with no significant difference in rates of hypertension between groups.

Overall, 12 eyes (1.9%) developed noninfectious endophthalmitis. However, the disease occurred significantly more often in eyes treated with preservative-containing triamcinolone.

Noninfectious endophthalmitis developed in 7.3% of eyes treated with preservative-containing triamcinolone vs. 1.2% of eyes that received preservative-free injections, the authors reported.

Eyes treated with preservative-containing triamcinolone also experienced more clinically relevant inflammatory reactions, they noted.

The study is published in the September issue of British Journal of Ophthalmology.