Table 15.
Triamcinolone safety
| DRCR Network 2008 (Ip et al/Beck et al/ Bressler et al) 22 61 63 64 | Gillies et al/Sutter et al32 136–138 | Gillies et al33 | Kim et al45 | Lam et al34 | Ockrim et al/ Sivaprasad et al42 62 | |
|---|---|---|---|---|---|---|
| Number of patients | ||||||
| Ocular adverse events | ||||||
| At 2 years (or 3 years when indicated) | At 2 years | – | Not reported | – | At 12 months | |
| IOP ≥30 mm Hg | IVT1: n=22; IVT4: n=53; L: n=3 | NR | NR | NR | IVT: IOP significantly higher than in L group (18.2 mm Hg, range 12–26 mm Hg); no cases of glaucoma | |
| IOP >22 mm Hg | NR | NR | NR | IVT: 37% (p=0.002 vs L); IVTL: 36% (p=0.002 vs L); L: 5% | NR | |
| IOP ≥10 mm Hg from baseline | IVT1: n=41; IVT4: n=85; L: n=12 | NR | NR | NR | NR | |
| IOP ≥5 mm Hg | NR | IVT: 68% (p=0.007 vs C); C: 10% | NR | NR | NR | |
| IOP lowering medication used | IVT1: n=31; IVT4: n=76; L: n=25 | IVT: 44% (p=0.0002 vs C); C: 3% | IVTL: 64% (p<0.001); L: 24% | NR | NR | |
| Cataract surgery | IVT1: 23% (of those phakic at baseline, 46% by 3 years (p<0.001 between all groups); IVT4: 51% (of those phakic at baseline, 83% by 3 years); L: 13% (of those phakic at baseline, 31% by 3 years) | IVT: 56% (of phakic eyes over 3 years, p<0.001 vs C); C: 8% (of phakic eyes over 3 years) | NR | NR | ||
| Ptosis | NR | NR | NR | NR | NR | |
| Retinal detachment | IVT1: n=2; IVT4: n=4; L: n=2 | NR | NR | None | NR | |
| Retinal vein occlusion | IVT1: n=1; IVT4: n=2; L: n=3 | NR | NR | NR | NR | |
| Retinal artery occlusion | IVT1: n=0; IVT4: n=0; L: n=1 | NR | NR | NR | NR | |
| Anterior ischemic optic neuropathy | IVT1: n=1; IVT4: n=0; L: n=0 | NR | NR | NR | NR | |
| Vitrectomy | IVT1: n=26; IVT4: n=19; L: n=31 | NR | NR | NR | NR | |
| Open angle glaucoma | IVT1: n=2; IVT4: n=7; L: n=2 | NR | NR | NR | NR | |
| Glaucoma filtering surgery | IVT1: n=0; IVT4: n=2; L: n=0 | NR | NR | NR | NR | |
| Laser trabeculoplasty | IVT1: n=0; IVT4: n=1; L: n=0 | IVT: n=2; C: n=0 | IVTL: n=1 | NR | NR | |
| Ciliary body destruction | IVT1: n=0; IVT4: n=1; L: n=0 | NR | NR | NR | NR | |
| Endophthalmitis | IVT1: n=0; IVT4: n=;0 L: n=0 | (Infectious) IVT: n=1; C: NR | (Culture-negative) IVTL: n=1 | None | (sterile) IVT: n=1 | |
| Pseudoendophthalmitis | IVT1: n=0; IVT4: n=;0 L: n=0 | NR | NR | NR | NR | |
| Chemosis | NR | NR | NR | NR | NR | |
| Percentage of increase in cataract scores | NR | NR | NR | IVT:+1.0 SD1.1 (p=NS vs L); IVTL:+1.3 SD1.9 (p=NS vs L); L:+0.5 SD0.9 | NR | |
| Ocular hypertension (>21 mm Hg) | NR | NR | NR | NR | NR | |
| Cataract progression | NR | NR | Phakic eyes, progression by ≥2 AREDS grade, IVTL: 64% (p<0.001); L: 11% (p<0.001) | NR | NR | |
| Corneal decompensation | NR | IVT: NR; C: n=1 | NR | NR | NR | |
| Cataract surgery | NR | NR | IVTL: 61% (p<0.001); L: 0% | NR | IVT: n=2; L: n=1 | |
| Vitreous haemorrhage | NR | NR | NR | IVTL: n=1 | ||
| Lens opacity | NR | NR | NR | NR | Significantly greater change in lens opacity in IVT group than in L group (1.9) | |
| Deaths | N=33, unrelated to study treatment | IVT: n=1; C: n=2 | IVTL: n=2; L: n=1 | NR | NR | |
CPL, control plus laser; IOP, intraocular pressure; NR, not reported; IVT, intravitreal triamcinolone; IVTL, intravitreal triamcinolone plus laser; RDL, ranibizumab plus deferred laser; RPL, ranibizumab plus laser; TPL, triamcinoloine plus laser.