Abstract

P 186

Prolonged decompensation of intraocular pressure following triamcinolone-injection for macula oedema with complete rehabilitation

Nicola  Rauch, Sabine Kurz, Norbert Pfeiffer
Universitäts-Augenklinik Mainz

Objective
After intravitreal triamcinolone-injection 50% percent of patients showed an elevation of intraocular pressure (IOP) starting about 2-8 weeks and and normalised about 6 Month after injection. In this case a 22 year old female patient developed decompensation of intraocular pressure (IOP) up to 61 mmHg following intravitreal injection of triamcinolone for macular oedema. Intraocular pressure normalized after 10 months.
Results
Initially the patient presented with diminished visual acuity 0,5 since 6 weeks on her left eye. Optical coherence tomography (OCT) as well as fluorescein angiography confirmed the clinical findings of a macula oedema. As a conservative treatment with local antiphlogistcs (Diclofenac 4xd, Prednisolon orally) over 3 months didn´t show any beneficial effect, we decided to administer 10 mg of triamcinolone intravitreally. 4 weeks postoperatively the patient presented with pain. Visual acuity was completely rehabilitated, but we measured an IOP of 30 mmHg. The IOP increased up to 61 mmHg after 5 months under local therapy with antiglaucomatosa and acetacolamide 500 mg orally. The chamber angle was open (Shaffer IV). Acetacolamide i.v. and local therapy could lower  IOP to 15 mmHg. After 10 months the acetacolamide and the local therapy could be stopped. In the 48h IOP measurement IOP was between 12 und 14 mmHg without therapy. The visual function was 1,0 without development of glaucomatous optic nerve head changes.
Conclusions
Tensiodecompensation by triamcinolone-injection can resolve spontaneously. This case shows us the possibility of the normalisation of IOP after 10 months. Therefore, the indication for surgical interventions (in 1-2%) should be carefully reviewed.

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