To investigate the association between elevated intraocular pressure (IOP) and accelerated cataract formation in patients treated with intravitreal triamcinol one. Analysis of longitudinal data from a randomized, doub...To investigate the association between elevated intraocular pressure (IOP) and accelerated cataract formation in patients treated with intravitreal triamcinol one. Analysis of longitudinal data from a randomized, double-masked, placebo-c ontrolled trial of intravitreal triamcinolone for age-related macular degenerat ion (the Intravitreal Triamcinolone Study). Patients with phakic eyes who partic ipated in a randomized clinical trial of intravitreal triamcinolone for age-rel ated macular degeneration were studied. There were 57 phakic eyes in the treatme nt group and 54 phakic eyes in the control group. One eye per patient was studie d. Four milligrams of intravitreal triamcinolone or 1 ml subconjunctival saline. Intraocular pressure rise of at least 5 mmHg (IOP responders) and progression o f posterior subcapsular cataract by 2 or more grades using photographic standard s from the Age Related Eye Disease Study. Progression of posterior subcapsular c ataract (PSC) by 2 or more grades in the treatment group was significantly highe r among 16 IOP responders (51%after 2 years) than among 37 nonresponders (3%; P < 0.0001, log-rank test). There was no significant progression of PSC in the placebo group or the opposite eye of the treatment group. Progression of cortica l cataracts also was significantly higher among responders than nonresponders (1 5%vs. 3%; P=0.015, log-rank test). The progression of nuclear cataracts (13% vs. 3%) was not significantly different between IOP responders and nonresponders (P=0.3, log-rank test). Although steroid-relate d cataracts are unlikely to develop in eyes that do not experience elevated IOP after intravitreal triamcinolone, those eyes that do also have a very high risk of rapidly experiencing posterior subcapsular lens opacification. This strong as sociation suggests that the mechanism responsible for the development of steroid -induced PSC cataract and raised IOP may be similar.展开更多
文摘To investigate the association between elevated intraocular pressure (IOP) and accelerated cataract formation in patients treated with intravitreal triamcinol one. Analysis of longitudinal data from a randomized, double-masked, placebo-c ontrolled trial of intravitreal triamcinolone for age-related macular degenerat ion (the Intravitreal Triamcinolone Study). Patients with phakic eyes who partic ipated in a randomized clinical trial of intravitreal triamcinolone for age-rel ated macular degeneration were studied. There were 57 phakic eyes in the treatme nt group and 54 phakic eyes in the control group. One eye per patient was studie d. Four milligrams of intravitreal triamcinolone or 1 ml subconjunctival saline. Intraocular pressure rise of at least 5 mmHg (IOP responders) and progression o f posterior subcapsular cataract by 2 or more grades using photographic standard s from the Age Related Eye Disease Study. Progression of posterior subcapsular c ataract (PSC) by 2 or more grades in the treatment group was significantly highe r among 16 IOP responders (51%after 2 years) than among 37 nonresponders (3%; P < 0.0001, log-rank test). There was no significant progression of PSC in the placebo group or the opposite eye of the treatment group. Progression of cortica l cataracts also was significantly higher among responders than nonresponders (1 5%vs. 3%; P=0.015, log-rank test). The progression of nuclear cataracts (13% vs. 3%) was not significantly different between IOP responders and nonresponders (P=0.3, log-rank test). Although steroid-relate d cataracts are unlikely to develop in eyes that do not experience elevated IOP after intravitreal triamcinolone, those eyes that do also have a very high risk of rapidly experiencing posterior subcapsular lens opacification. This strong as sociation suggests that the mechanism responsible for the development of steroid -induced PSC cataract and raised IOP may be similar.
