Incidence and Factors Associated with Ocular Hypertension after Intravitreal Triamcinolone Injection among Macula Oedema Patients Attending KCMC (2024-2025)

Abstract

Background: Intravitreal triamcinolone acetonide (IVTA) is an effective cor ticosteroid used in managing retinal conditions such as cystoid macular edema (CME), diabetic macular edema (DME), and retinal vein occlusion (RVO). Despite its therapeutic benefits, IVTA is known to cause ocular hypertension (OHT), which can lead to irreversible glaucomatous damage if not adequately monitored, posing a particular challenge in resource-limited settings. Objectives: To determine the incidence, pattern, and associated risk factors of ocular hypertension following intravitreal triamcinolone injection among patients with macular edema attending the Ophthalmology Department at Kilimanjaro Christian Medical Centre (KCMC) between 2024 and 2025. Methods: A prospective cohort study was conducted involving 110 adult patients diagnosed with macular edema and treated with a standardized 4 mg dose of IVTA. Intraocular pressure (IOP) was measured at baseline, immediately post-injection, and at 2-week and 6-week follow-up visits using an Icare tonometer. OHT was defined as IOP > 21 mmHg or an increase ≥5 mmHg or 20% from baseline. Statistical analysis was performed using SPSS 25, with multivariate regression applied to identify independent predictors of OHT. Results: The incidence of ocular hypertension was 35%. Mean IOP rose significantly from 14.59 mmHg at baseline to 28.42 mmHg immediately post-injection, decreasing to 17.75 mmHg at 2 weeks and 17.05 mmHg at 6 weeks (p < 0.001). Retinal vein occlusion was the strongest independent predictor of OHT (ARR = 3.23; 95% CI: 1.10–9.54; p = 0.033). Conclusion: IVTA is associated with a high incidence of transient and sustained OHT. Early and routine IOP monitoring, especially in RVO patients, is crucial to prevent glaucomatous complications, particularly in low-resource settings.