Abstract
Purpose
To determine the incidence of cataract following intravitreal triamcinolone (IVTA) for diabetic macular oedema.
Methods
Prospective, non-randomised, interventional cohort case series. A total of 27 eyes of 27 patients with diabetic macular oedema received an intravitreal injection of 4 mg (0.1 ml) of triamcinolone acetonide inferotemporally through the pars plana under direct vision. In 20 patients the fellow eye served as control, whereas seven patients had both eyes injected (not simultaneously). Seven patients had a repeat (second) injection in the same eye. The main outcome measures were cataract and intraocular pressure (IOP) rise of at least 5 mmHg (IOP responder).
Results
The mean follow-up time was 18.9 months (range 13–29 months). A total of 22 (81%) of 27 eyes developed cataract during the follow-up period, of which 20 (74%) were posterior subcapsular in nature. None of the 20 uninjected fellow eyes developed posterior subcapsular cataract. Mean time to cataract formation was 16.2 months. In the seven patients who had both eyes injected, mean time to cataract formation was 16.5 and 17.1 months in the first and second eye, respectively. Mean time to cataract formation in seven eyes receiving a repeat second injection was 17.9 months. There was no significant difference in cataract formation between IOP responders (85%) and non-responders (79%) (P=1.00, Fisher's exact test). Uneventful cataract surgery was performed in six eyes of five patients.
Conclusion
This study demonstrates that given appropriate long-term follow-up, the majority of patients, even after a single IVTA injection, will go on to develop cataract, of which posterior subcapsular will be by far the most common.
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References
Martidis A, Duker JS, Greenberg PB, Rogers AH, Puliafito CA, Reichel E et al. Intravitreal triamcinolone for refractory diabetic macular oedema. Ophthalmology 2002; 109: 920–927.
Massin P, Audren F, Haouchine B, Erginay A, Bergmann JF, Benosman R et al. Intravitreal triamcinolone acetonide for diabetic diffuse macular oedema. Ophthalmology 2004; 111: 218–225.
Sutter FKP, Simpson JM, Gillies MC . Intravitreal triamcinolone for diabetic macular oedema that persists after laser treatment. Ophthalmology 2004; 111: 2044–2049.
Karacorlu M, Ozdemir H, Karacorlu S, Alacali N, Mudun B, Burumcek E . Intravitreal triamcinolone as a primary therapy in diabetic macular oedema. Eye, advance online publication 13. 8. 04 sj.eye.6701512.
Ozkkiris A, Evereklioglu C, Erkilic K, Tamcelik N, Mirza E . Intravitreal triamcinolone acetonide injection as a primary treatment for diabetic macular oedema. Eur J Ophthalmol 2004; 14 (6): 543–549.
Negi AK, Vernon SA, Lim CS, Owen-Armstrong K . Intravitreal triamcinolone improves vision in eyes with chronic diabetic macular oedema refractory to laser photocoagulation. Eye 2004 (E-pub ahead of print).
Islam MS, Negi A, Vernon SA . Improved visual acuity and macular thickness 1 week after intravitreal triamcinolone for diabetic macular oedema. Eye 2004 (E-pub ahead of print).
Kanski JJ . Clinical Ophthalmology A Systematic Approach, 5th Ed. p 167.
Gupta R, Negi AK, Vernon SA . Severe sub-conjunctival haemorrhage following Intravitreal triamcinolone for refractory diabetic oedema. Eye 2005; 19: 590–591.
Jonas JB, Kreissig I, Sofker A, Degenring RF . Intravitreal injection of triamcinolone for diffuse diabetic macular oedema. Arch Ophthalmol 2003; 121: 57–61.
Ciardella AP, Klancnik J, Schiff W, Barile G, Langton K, Chang S . Intravitreal triamcinolone for the treatment of refractory diabetic macular oedema with hard exudates: an ocular coherence tomography study. Br J Ophthalmol 2004; 88: 1131–1136.
Lam DSC, Chan CKM, Tang EWH, Li KKW, Fan DSP, Chan WM . Intravitreal triamcinolone for diabetic macular oedema in Chinese patients: six month prospective longitudinal pilot study. Clin Exp Ophthalmol 2004; 32: 569–572.
Gillies MC, Simpson JM, Billson FA, Luo W, Penfold P, Chua W et al. Safety of an intravitreal injection of triamcinolone. Arch Ophthalmol 2004; 122: 336–340.
Gillies MC, Kuzniarz M, Craig J, Ball M, Luo W, Simpson JM . Intravitreal triamcinolone-induced elevated intraocular pressure is associated with the development of posterior subcapsular cataract. Ophthalmology 2005; 112: 139–143.
Flynn HW, Scott IU . Intravitreal triamcinolone acetonide for macular oedema associated with diabetic retinopathy and venous occlusive disease: it's time for clinical trials. Arch Ophthalmol 2005; 123: 258–259.
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Islam, M., Vernon, S. & Negi, A. Intravitreal triamcinolone will cause posterior subcapsular cataract in most eyes with diabetic maculopathy within 2 years. Eye 21, 321–323 (2007). https://doi.org/10.1038/sj.eye.6702304
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DOI: https://doi.org/10.1038/sj.eye.6702304
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