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Objective:To describe the natural history of intraocular pressure(IOP) within the first 30 minutes after intravitreal injection of triamcinolone acetonide(TA) .Design:Prospective,interventional,consecutive case series.Participants:Thirty-eight consecutive patients who met inclusion and exclusion criteria and underwent intravitreal injection of 0.1 ml(4 mg) of TA were studied.Methods:Intraocular pressure was measured by Goldmann applanation tonometry at baseline;immediately after injection;and at 2,5,10,20,and 30 minutes after injection.Main Outcome Measures:Intraocular pressure measurements at baseline;immediately after intravitreal injection;and 2,5,10,20,and 30 minutes after injection,and percentage of patients with IOP ≤ 24 mmHg at 30 minutes.Results:Patients who did not experience vitreous reflux(30/38 [78.9% ]) at the site of injection had a significant initial elevation of IOP that rapidly normalized.Patients who experienced vitreous reflux(8/38 [21.1% ]) at the site of injection had either no change in IOP or a small drop in IOP that rapidly normalized.The IOP measured in millimeters of mercury immediately after injection(45.9 [no reflux],12.6 [reflux]) ,2 minutes after injection(39.9 [no reflux],13.5 [reflux]) ,5 minutes after injection(33.3 [no reflux],13.8 [reflux]) ,10 minutes after injection(26.4 [no reflux],15.1 [reflux]) ,and 20 minutes after injection(21.8 [no reflux],15.0 [reflux]) showed a statistically significant difference between the 2 groups.The difference in IOP between the 2 groups was not significant at baseline or 30 minutes after injection.At 30 minutes,90%(95% confidence interval,85.8%-95.2%) of patients without vitreous reflux had an IOP < 24 mmHg.Conclusions:Patients undergoing intravitreal injection of TA with no vitreous reflux have a risk of short-term elevation of IOP that rapidly normalizes over 30 minutes.In patients with vitreous reflux after the injection,the IOP declines immediately after injection and rapidly normalizes over 10 minutes.
Objective: To describe the natural history of intraocular pressure (IOP) within the first 30 minutes after intravitreal injection of triamcinolone acetonide (TA). Design: Prospective, interventional, consecutive case series. Participants: Thirty-eight consecutive patients who met inclusion and exclusion criteria and underwent intravitreal injection of 0.1 ml (4 mg) of TA were studied. Methods: Intraocular pressure was measured by Goldmann applanation tonometry at baseline; immediately after injection; and at 2,5,10,20, and 30 minutes after injection. Main Outcome Measures: Intraocular pressure measurements at baseline; immediately after intravitreal injection; and 2,5,10,20, and 30 minutes after injection, and percentage of patients with IOP ≤ 24 mmHg at 30 minutes. Results: Patients who did not experience vitreous reflux (30/38 [78.9%]) at the site of injection had a significant initial elevation of IOP that rapidly normalized. Patients who experienced vitreous reflux (8/38 [21.1%]) at the site of injecti on had either no change in IOP or a small drop in IOP that rapidly normalized. IOP measured in millimeters of mercury immediately after injection (45.9 [no reflux], 12.6 [reflux]), 2 minutes after injection (39.9 [no reflux] , 13.5 [reflux]), 5 minutes after injection (33.3 [no reflux], 13.8 [reflux]), 10 minutes after injection (26.4 [no reflux], 15.1 [reflux] showed a statistically significant difference between the 2 groups. The difference in IOP between the 2 groups was not significant at baseline or 30 minutes after the injection. At 30 minutes, 90% (95% confidence interval, 85.8 % -95.2%) of patients without vitreous reflux had an IOP <24 mmHg.Conclusions: Patients undergoing intravitreal injection of TA with no vitreous reflux have a risk of short-term elevation of IOP that rapidly normalizes over 30 minutes. Patients with vitreous reflux after the injection, the IOP declines immediately after injection and rapidly normalizes over 10 minutes.