Raised intraocular pressure following Intravitreal Triamcinolone Acetonide in diabetic versus non-diabetic patients

Objective: To determine the frequency of an increase in intraocular pressure (IOP) after intravitreal triamcinolone acetonide (IVTA) in diabetic versus non-diabetic patients with various chorio-retinal disorders.

Methods: This prospective, interventional comparative case series was conducted at Isra Postgraduate Institute of Ophthalmology, Al-Ibrahim Eye Hospital, Karachi from May 2012 to April 2014. Two hundred thirty seven eyes of 180 patients were enrolled with 90 patients each in diabetic and non-diabetic group, requiring IVTA. IVTA 4mg/0.1ml was injected and IOP was measured at one week, one month, three months and six months in both groups of patients.

Results: In diabetic group, 43 patients were male (47.8%) and 47 were female (52.2%), while in non-diabetic group, 56 (62.2%) patients were male and 34 (37.8%) were female. Mean age of patients in diabetic group was 52.21 ± 9.6 years and in non-diabetic group was 51.13 ± 10.75 years. The mean preoperative IOP was 13.6 ± 2.8 mmHg and 14.1 ± 2.4 mmHg in diabetic and non-diabetic group respectively. In diabetic group, mean (±SD) IOP was 16.4 ±4.9 mmHg, 14.6 ±3.6 mmHg, 17.6 ± 9.7 mmHg and 15.5 ± 7.09 mmHg at one week, one month , three months and 6 months post injection. While in non-diabetic cases, mean (±SD) IOP was 14.8 ± 3.33 mmHg, 15.9 ± 4.2 mmHg, 15.5 ± 4.2 mmHg and 14.1 ± 3.2 mmHg at one week, one month, three months and 6 months follow up. The raised IOP was observed in 117 eyes (49%) in both groups of patients, with 78 eyes (65%) in diabetic group and 39 eyes (33%) in non-diabetic group.

Conclusions: After IVTA, an IOP rise was observed more in diabetics than non-diabetic patients.