Triamcinolone raises risk for increased IOP, cataract progression in uveitic eyes with macular edema

Using intravitreal triamcinolone acetonide to treat macular edema is more likely to cause increases in IOP and progression of posterior subcapsular cataract in uveitic patients compared with those with macular edema resulting from other causes, a retrospective study found. "Patients with uveitis treated with [intravitreal triamcinolone] should be counseled about these risks and monitored closely," the study authors said.

Anat Galor, MD, and colleagues reviewed outcomes for 222 eyes of 173 macular edema patients treated with intravitreal triamcinolone acetonide. Of these patients, macular edema was caused by uveitis in 45 eyes of 31 patients and was secondary to other etiologies in 177 eyes of 142 patients, according to the study.

All patients received treatment at the Cole Eye Institute in Cleveland between 2001 and 2005.

Investigators found that uveitis patients were significantly younger than non-uveitis patients. Uveitis patients were also more likely to be women and to have had previous steroid injections into the posterior sub-Tenon's capsule either with or without treatment for glaucoma, according to the study.

After adjusting for these factors, multivariate analysis showed that uveitis was the strongest risk factor for a post-injection IOP adverse event (P = .05), the authors reported.

In addition, uveitic eyes had a 5.6 times higher chance for experiencing a documented increase in posterior subcapsular cataract after injection (P = .007), they noted.

The study is published in the October issue of Ophthalmology.