Short-term complications of intravitreal injection of triamcinolone acetonide

Purpose: To describe the short-term complications associated with intravitreal triamcinolone acetonide (IVTA) injection in the treatment of posterior segment disorders. Methods: The medical records of 784 patients (929 consecutive eyes) were retrospectively reviewed at a single institution. One or more IVTA injections for treatment of a variety of steroid-responsive posterior segment disorders (predominantly diabetic macular edema, choroidal neovascularization, and retinal venous occlusions) were administered. Adverse events occurring within 3 months of the initial injection were identified. Results: The most common adverse event occurring within 3 months after the initial injection was steroid-related ocular hypertension, with intraocular pressure spikes of >21 mm Hg in 21% of eyes and >25 mm Hg in 11% of eyes. Ocular inflammation occurred in six eyes (0.6%): four eyes with sterile hypopyon and two eyes without hypopyon. Three eyes (0.3%) had corneal epithelial defects thought to be related to pretreatment with povidone-iodine solution. No eyes had culture-positive infectious endophthalmitis. Cataract progression was not assessed in this analysis. Conclusion: IVTA injection for the treatment of steroid-responsive disorders of the posterior segment, when administered under sterile conditions, is associated with a low incidence of serious vision-threatening adverse events within the first 3 months after injection.