Effect of single intravitreal triamcinolone acetonide injection on intraocular pressure and retinal nerve fibre layer thickness

Purpose: To investigate the intraocular pressure (IOP) changes following intravitreal triamcinolone acetonide (IVTA) injection for inflammatory, proliferative and edematous diseases of posterior segment of eye. Design: Prospective longitudinal interventional study. Methods: The prospective longitudinal study included 30 with posterior uveitis (n=12), retinal vascular occlusive diseases (n=10), Eales’ disease (n=6), pseudophakic cystoid macular edema (n=1) and idiopathic cystoid macular edema (n=1). 4 mg of IVTA injection IOP increased significantly from baseline IOP of 14.27±3.53 mm Hg to mean IOP of 16.54± 4.29, 18.54± 5.50, 19.00± 5.98, 18.82± 5.00 and 22.50±0.71 mm Hg at 2, 4, 6, 8 and 12 weeks follow up respectively. In study group IOP elevation of ≥6 mm Hg from baseline was seen in 17 out of 30 eyes (64.71% males and 35.29%females). The majority of patients belonged to younger age group. An IOP elevation was seen in 58.82% and 88.24% eyes upto 4 and 6 weeks follow up respectively. In 15 out of 17 eyes, IOP was controlled with topical anti-glaucoma medications while 2 eyes required filtering glaucoma surgery. Conclusions: After 4 mg of IVTA injection 57.67% of eyes developed IOP elevation ≥6 mm Hg from baseline. In 88.24% eyes raised IOP was controlled with topical anti-glaucoma medications. There was no statistically significant change observed in retinal nerve fibre layer thickness upto 12 weeks follow up, despite elevated IOP. Besides glaucoma no other complication was observed upto 12 weeks of follow up.