UK national survey of current practice and experience of intravitreal triamcinolone acetonide

In recent years, intravitreal triamcinolone acetonide (IVTA) injections have become widely used in the treatment of macular oedema. IVTA can cause elevation of intraocular pressure (IOP), which can be sight threatening. We carried out a nationwide study, which aimed to (i) assess the current usage of IVTA, (ii) estimate the incidence of 'severe' IOP rise following IVTA, in routine practice.

A postal survey was carried out in January 2007. A questionnaire was mailed to senior ophthalmologists (all consultants and associate specialists) in the United Kingdom. We asked about the use of IVTA over the past year and whether there had been any cases of severe IOP rise (defined as elevation in IOP, commencing after IVTA therapy, requiring laser or surgery to treat the raised pressure).

Response rate was 56% (611/1089). Among respondents, 33% (206) had used IVTA during the 12 months of 2006 giving a total of 3899 IVTA injections. There were 45 reported cases of severe IOP rise, following IVTA injections, which were given under their care of the respondent. A further 28 cases were reported to have been referred from colleagues; it is unclear whether any or all of these cases were included in the initial 45. The reported rate of severe IOP rise following IVTA was therefore at least 45/3899 or at least 1.1%.

Usage of IVTA in the United Kingdom is widespread. Severe IOP rise, requiring laser or surgery to control IOP, was reported in at least 1.1% of cases.