Study links age, gender to elevated IOP after triamcinolone injections

Age younger than 60 years and female gender may be risk factors for elevated IOP after intravitreal steroid therapy to treat inflammatory, neovascular, proliferative and edematous diseases, according to a study by researchers in Japan.

Additionally, IOP elevations may persist longer after posterior sub-Tenon injections compared with intravitreal injections, the study authors noted.

"Careful assessment of IOP during a follow-up period of at least 6 months is paramount, especially in younger female patients after posterior sub-Tenon injection," they said in the study.

Yumiko Yamamoto, MD, and colleagues at Kochi Medical School in Nankoku City obtained IOP measurements for 82 eyes of 69 patients. Of these cases, 16 eyes were treated with a 4-mg intravitreal injection of triamcinolone acetonide and 66 eyes received a 20-mg posterior sub-Tenon injection, according to the study.

At each follow-up point, IOP had increased significantly in all cases, with a mean maximum elevation ratio of 4 mm Hg from baseline, the authors reported.

IOP increased 5 mm Hg or more in 28 eyes (34.1%). Additionally, patients younger than 60 years had a significantly higher rate of IOP increases of 5 mm Hg or more (P < .01), and women also had a "relatively higher" rate of such IOP increases, they reported.

Mean IOP increased significantly at 1 month follow-up in patients who had received intravitreal injections; however, mean IOP increased at all follow-up periods in patients who had received posterior sub-Tenon injections, the authors noted.

"There was no significant difference in IOP elevation according to disease type, although eyes with diabetic retinopathy tended to be at higher risk of IOP elevation," the authors said.

The study is published in the February issue of Canadian Journal of Ophthalmology.