Acute glaucoma secondary to angle obstruction by triamcinolone crystals

Area of Science:

• Ophthalmology
• Pharmacology

Background:

• Cystoid macular edema is a common cause of vision loss.
• Intravitreal corticosteroids, such as triamcinolone acetonide, are used to treat inflammatory eye conditions.
• Pseudophakic and vitrectomized eyes represent a unique patient population with altered ocular anatomy.

Purpose of the Study:

• To report a case of acute secondary glaucoma.
• To highlight the risk of triamcinolone acetonide migration into the anterior chamber.
• To emphasize the importance of monitoring intraocular pressure after intravitreal injections in specific patient groups.

Main Methods:

• A case study was conducted at Manchester Royal Eye Hospital.
• The study involved a patient who received an intravitreal injection of triamcinolone acetonide.
• The patient had a history of vitrectomy and was pseudophakic.

Main Results:

• Massive transit of triamcinolone acetonide into the anterior chamber occurred post-injection.
• This led to the development of acute glaucoma.
• The patient's eye was pseudophakic and vitrectomized with an open posterior capsule.

Conclusions:

• High-dose intravitreal triamcinolone in vitrectomized eyes with an open posterior capsule poses a risk of acute glaucoma.
• Close monitoring of intraocular pressure within one week of injection is crucial.
• This proactive approach can help prevent vision-threatening complications.