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Topical steroid trial may predict IOP response after intravitreal triamcinolone
Can J Ophthalmol. 2010;45(5):484-488.
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A trial with topical steroids may be predictive of severe IOP spikes after intravitreal injection, according to a study.
The retrospective study, which culled data from charts of 1,150 patients, included 172 patients who received intravitreal triamcinolone acetonide. Of these 172 patients, 97 received a topical prednisolone acetate trial (PAT) and 75 were controls.
The investigators found that patients receiving a 6-week course of 1% prednisolone acetate four times daily who did not experience a significant IOP rise after treatment had a lower proportional rise between maximum IOP and baseline after subsequent intravitreal triamcinolone injection compared with patients who did not undergo a PAT (43% vs. 64%).
Patients in the treatment arm were also less likely to incur a maximum IOP of 40 mm Hg or greater after triamcinolone injection.
Presumably, the study authors said, patients who had an IOP elevation after the PAT would most likely also have an IOP elevation after triamcinolone but were filtered from the analysis, thereby leaving a lower-risk group compared with patients who did not undergo a PAT.
"The results of this large retrospective cohort study of patients being treated with [intravitreal triamcinolone] shows that those undergoing a PAT (without a short-term IOP rise) have a lower risk of severe IOP spikes compared with those not undergoing a PAT," the study authors wrote.