Reply

Abstract

Drs Lin, Tsai, and Hung have a major concern regarding our article that appeared in the June issue. 1 Hayashi K. Hayashi H. Intravitreal versus retrobulbar injections of triamcinolone for macular edema associated with branch retinal vein occlusion. Am J Ophthalmol. 2005; 139: 972-982 Abstract Full Text Full Text PDF PubMed Scopus (68) Google Scholar In that article, we reported that intravitreal triamcinolone immediately and substantially reduces macular edema associated with branch retinal vein occlusion (BRVO). However, an increase in intraocular pressure (IOP) to 20 mm Hg or more occurred in 33% of the eyes that underwent intravitreal injection. Specifically, it has been reported that younger age is a risk factor for a marked elevation in IOP after intravitreal injection of triamcinolone. 2 Jonas J.B. Degenring R.F. Kreissig I. et al. Intraocular pressure elevation after intravitreal triamcinolone acetonide injection. Ophthalmology. 2005; 112: 593-598 Abstract Full Text Full Text PDF PubMed Scopus (287) Google Scholar , 3 Park H.Y. Yi K. Kim H.K. Intraocular pressure elevation after intravitreal triamcinolone injection. Korean J Ophthalmol. 2005; 19: 122-127 Crossref PubMed Scopus (40) Google Scholar Dr Lin and colleagues had three patients younger than 40 years of age who experienced uncontrolled elevation of IOP after intravitreal injection; accordingly, they assert that intravitreal injection of triamcinolone should not be performed in patients younger than 45. Intravitreal Versus Retrobulbar Injection of Triamcinolone for Young PatientsAmerican Journal of OphthalmologyVol. 141Issue 1PreviewIn the article by Hayashi and Hayashi,1 the authors demonstrated that a single intravitreal injection of triamcinolone is far more effective than are repeated retrobulbar injections in reducing macular edema associated with branch retinal vein occlusion (BRVO) and leads to greater improvement in visual acuity. However, the incidence of intraocular pressure (IOP) increase was greater in the intravitreal group than in the retrobulbar group. Although we agreed with the results of authors, there are some points that we would like to add in this regard. Full-Text PDF