Efficacy of Screening with Topical Steroids before Intravitreal Triamcinolone Injection

ABSTRACT

PURPOSE: To evaluate the efficacy of screening of high risk groups with topical steroids due to increased ocular pressure by intravitreal triamocinolone injection (IVTA). METHODS: We selected 96 eyes that had undergone IVTA between January 2003 and December 2004. The screening method used was as follows; We administered 4 drops daily of prednisolone (1%) eye drops for 3weeks and included patients with an intraocular pressure increase of less than 5 mmHg for the procedure. Two groups consisting of the post-screening IVTA group (group A) and non-screening group (group B) were classified, and intraocular pressure was measured using a Goldman applanation tonometer at 1 week, 1 month, 2 months, 3 months and 6 months after the procedure. RESULTS: One patient in group A (3.1%) required glaucoma medication compared with 10 patients in group B (17.9%), and one of these group B patients required surgical intervention. Chi-square analysis showed a statistically significant reduction in glaucoma medication use in group A compared with group B (P<0.05). Group B had a higher percentage of patients with an increase of intraocular pressure over 5 mmHg compared with values before the procedure, particularly in the second and third months after the procedure. CONCLUSIONS: IVTA after screening resulted in less use of glaucoma medication and a reduced rate of increase in intraocular pressure. Complications due to increased intraocular pressure by IVTA can be minimized by screening high risk groups.