Posterior Subtenon Injection Research Articles

Bilateral Nongranulomatous Uveitis with Infective Endocarditis

A 32-year-old male who had infective endocarditis complained of photophobia and blurred vision in both eyes. Biomicroscopic examination and fundus examination revealed anterior chamber reaction, vitritis, optic disc swelling, and Roth spots. He was diagnosed with bilateral nongranulomatous uveitis and treated with topical steroid eye drops and posterior sub-Tenon injection of triamcinolone. His visual symptoms were resolved within 1 week, and inflammation resolved within 4 weeks after treatment.

Sequential posterior subtenon injection of triamcinolone acetonide with macular grid/focal photocoagulation for clinically significant diabetic macular edema

PurposeTo evaluate the efficacy of sequential posterior subtenon triamcinolone acetonide (PSTA) injection with macular grid/focal laser photocoagulation for clinically significant diabetic macular edema (CSME). MethodsProspective, interventional clinical trial. Between July 2007 and March 2008, 41 eyes of 32 patients (17 males and 15 females) with Type II diabetes mellitus and diffuse clinically significant macular edema according to the Early Treatment Diabetic Retinopathy Study criteria were recruited. PSTA was used as the first line of treatment, followed by macular focal/grid photocoagulation 2 weeks later. In patients with persistent macular edema, a second dose of PSTA followed by additional focal laser treatment was administered 8–10 weeks later. ResultsBest-corrected visual acuity (BCVA) calculated as logarithm of the minimum angle of resolution (logMAR) unit showed significant improvement both after 3 weeks (0.79±0.27, p=0.001) and after 6 months (0.77±0.29, p=0.001) in comparison with the baseline values 0.92±0.24. Central macular thickness (CMT) was significantly reduced both after 3 weeks (336.2±125.8μm, p=0.001) and after 6 months (342.2±127.2μm, p=0.001) in comparison with the baseline values 437.1±186.5μm. Total macular volume (TMV) was also significantly reduced both after 3 weeks (10.2±1.8mm3, p<0.05) and after 6 months (10.3±2.0mm3, p<0.05) in comparison with the baseline values 11.9±2.1mm3. There were no significant differences in BCVA, CMT, and TMV between 3 weeks and 6 months posttreatment. ConclusionOne or two sessions of sequential PSTA injection and macular grid/focal photocoagulation may improve or stabilize visual acuity, CMT, and TMV for at least 6 months in patients with CSME.

COMPARISON OF INTRAOCULAR PRESSURE ELEVATION AFTER ANTERIOR VERSUS POSTERIOR SUBTENON TRIAMCINOLONE ACETONIDE ACETATE INJECTION

To compare the profiles of elevated intraocular pressure (IOP) after anterior and posterior subtenon injections (PSTIs) of triamcinolone. In this retrospective case series, 131 patients (131 eyes) with a single anterior subtenon injection (ASTI) of triamcinolone acetonide acetate (20 mg in 0.5 mL) and 49 patients (49 eyes) with a single PSTI of triamcinolone acetonide acetate (40 mg in 0.4 mL) were studied for changes in IOP. Changes in IOP compared with the baseline and fellow eyes were analyzed for both the ASTI and PSTI groups. The study revealed that ASTI was 2.4 times more likely (95% confidence interval, 1.02-5.9) to have an IOP elevation >21 mmHg when compared with the PSTI (P = 0.0389). Twenty-one percent (28 of 131) of eyes having an IOP >21 mmHg were found in the ASTI group, while only 12% (6 of 49) were found in the PSTI group. Similarly, ASTI was 5.3 times more likely (95% confidence interval, 1.2-22.5) to have an IOP >30 mmHg compared with the PSTI (P = 0.03, one-tailed). Anterior subtenon injection had 7% (9 of 131) of eyes with IOP >30 mmHg, while only 2% (1 of 49) were present in the PSTI group. Age was negatively associated with IOP elevation (P < 0.05), and the baseline IOP was positively associated with IOP elevation (P < 0.05). The mean IOP elevation from the baseline was also found to be greater in ASTI (3.1 mmHg) than in PSTI (1.8 mmHg; P = 0.02, generalized estimating equation). An ASTI of triamcinolone acetonide may bear a higher risk of developing elevated IOP than a PSTI of triamcinolone acetonide.

One-year results of bevacizumab intravitreal and posterior sub-Tenon injection of triamcinolone acetonide with reduced laser fluence photodynamic therapy for retinal angiomatous proliferation

Our aim was to study the efficacy of combined triple therapy with intravitreal bevacizumab injections (IVB), posterior sub-Tenon injection of triamcinolone acetonide (STTA), and reduced laser fluence photodynamic therapy (RFPDT) in Japanese patients with retinal angiomatous proliferation (RAP). This was a retrospective, observational, consecutive case series. Fifteen consecutive RAP treatment-naïve eyes were treated with triple therapy of IVB, STTA, and RFPDT (25 J/cm(2) of laser fluence). Whenever there was a recurrence of retinal-retinal anastomosis (RRA) or retinal-choroidal anastomosis (RCA) and marked leakage from subretinal neovascularization, the triple therapy was reapplied. When there were only intraretinal exudative and/or hemorrhagic changes without distinct RRA or RCA, IVB alone was applied. The mean logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) at baseline improved significantly (from 0.489 to 0.294 12 months) (paired t test, p = 0.043). LogMAR BCVA at 12 months was stable or improved by ≥ 0.2 in 14 eyes (93.3 %). Mean number of triple therapy instituted during the 12-month study period was 1.2, and mean number of IVB treatments was 1.4. Combined IVB, STTA, and RFPDT for RAP was effective in maintaining or improving VA at 1 year. In addition, the number of treatments could be markedly reduced.

Pharmacokinetic Study of Vitreous and Serum Concentrations of Triamcinolone Acetonide After Posterior Sub-Tenon's Injection

To compare a theoretical pharmacokinetic model of triamcinolone acetonide after posterior sub-Tenon's injection with experimental serum and undiluted vitreous triamcinolone acetonide concentrations obtained during pars plana vitrectomy. Clinical-practice, prospective, interventional case series study. This study compared computer-modeled triamcinolone acetonide diffusion after posterior sub-Tenon's injection with triamcinolone acetonide levels in experimental undiluted vitreous and serum samples from 57 patients undergoing vitrectomy assessed via mass spectrometry and high-pressure liquid chromatography. At least 5 pairs of samples were collected at each of 7 time points (1 day, 3 days, and 1, 2, 3, 4, and 8 weeks) after triamcinolone acetonide injection, with 6 controls without injection. Cortisol levels were measured in 31 sets of samples. The theoretical model predicted that triamcinolone acetonide levels in systemic blood, vitreous, and choroidal extracellular matrix would plateau after 3 days at 15 ng/mL, 227 ng/mL and 2230 ng/mL, respectively. Experimental vitreous levels of triamcinolone peaked at 111 ng/mL at day 1, then reached a plateau in the range 15 to 25 ng/mL, while serum triamcinolone levels peaked at day 3 near 35 ng/mL and plateaued near 2 to 8 ng/mL. Serum triamcinolone and cortisol levels were inversely correlated (Spearman -0.42, P = .02). The theoretical model predicts efficient delivery of triamcinolone acetonide from the posterior sub-Tenon's space to the extracellular choroidal matrix. The experimental findings demonstrate low levels of serum triamcinolone that alter systemic cortisol levels and higher vitreous levels lasting at least 1 month. Both assessments support trans-scleral delivery of posterior sub-Tenon's triamcinolone.

Effect of photodynamic therapy (PDT), posterior subtenon injection of triamcinolone acetonide with PDT, and intravitreal injection of ranibizumab with PDT for retinal angiomatous proliferation

BackgroundThe purpose of this work was to compare the efficacy of photodynamic therapy (PDT) with or without posterior subtenon injections of triamcinolone acetonide (STA) or intravitreal injections of ranibizumab (IVR) for retinal angiomatous proliferation (RAP).MethodsThirty-seven eyes from 33 consecutive patients with RAP were treated by PDT monotherapy (Group 1), PDT combined with STA (Group 2), or PDT combined with IVR (Group 3). The best-corrected visual acuity, greatest linear dimension, central retinal thickness, and number of treatments were compared among the three groups.ResultsThe change in mean best-corrected visual acuity (logMAR) at month 3, 6, and 12 after the initial treatment was better in Group 2 (−0.13, −0.23, and −0.21, respectively) and Group 3 (−0.018, 0.0028, and −0.0067, respectively) than in Group 1 (0.13, 0.19, and 0.23, respectively); Group 1 versus Group 2 was statistically significant (P = 0.018). The mean central retinal thickness was reduced from baseline in all groups, but the reduction amplitude was significantly greater in Group 2 than in Group 1 and Group 3. The mean number of treatments was significantly lower in Group 2 (1.1 ± 0.4) and Group 3 (1.5 ± 0.5) than in Group 1 (2.9 ± 0.9) in the 12 months after the initial treatment.ConclusionTreatment with STA + PDT may be an effective therapy for RAP lesions over 12 months of follow-up.

Intraocular and Systemic Pharmacokinetics of Triamcinolone Acetonide after a Single 40-mg Posterior Subtenon Application

To characterize the pharmacokinetics of triamcinolone acetonide (TA) in aqueous, vitreous, and systemic circulation after a single subtenon injection. Prospective interventional case series. Thirty-six patients (36 eyes) who received a single posterior subtenon injection of TA (40 mg in 0.4 ml). Aqueous, vitreous, and blood samples were obtained at 1-hour, 1-day, 3-day, 5-day, 10-day, 14-day, 21-day, and 28-day time points after the posterior subtenon TA injection. At each time point, there were 3 to 6 eyes (patients). The concentrations of TA in the aqueous, vitreous, and plasma were analyzed using ultra-performance liquid chromatography coupled with tandem mass spectrometry. Triamcinolone acetonide concentration in the samples was measured, and pharmacokinetic parameters were calculated. The TA concentration-time profile in aqueous consisted of a fast distribution phase during the first 24 hours and a slow elimination phase thereafter. In contrast, the TA concentration-time profile in vitreous consisted of an absorption phase during the first 24 hours followed by a slow elimination phase. The TA in plasma followed a mono-exponential elimination during the study course. The TA concentration peak time for aqueous and plasma was at 1 hour and 24 hours, for vitreous after subtenon injection. The terminal elimination half-life in aqueous, vitreous, and plasma was 11.8, 17.1, and 25 days, respectively. The integral of the area under the concentration time curve (AUC(0-∞)) was 862 ng/day/ml for aqueous, 1262 ng/day/ml for vitreous, and 17.4 ng/day/ml for plasma. The total TA exposure to vitreous was 46% more than total TA exposure to the aqueous. The TA concentration in vitreous was 70- to 98-fold higher than that in plasma. Posterior subtenon TA application can provide a sustained high local ocular TA level while also resulting in a very low systemic TA level, which may be well below the normal glucocorticoid level in humans.

Juxtapapillary capillary hemangioma treated by intravitreal injection of bevacizumab combined with posterior subtenon injection of triamcinolone acetonide

Juxtapapillary capillary hemangioma treated by intravitreal injection of bevacizumab combined with posterior subtenon injection of triamcinolone acetonide

EFFECT OF PHOTODYNAMIC THERAPY ALONE OR COMBINED WITH POSTERIOR SUBTENON TRIAMCINOLONE ACETONIDE OR INTRAVITREAL BEVACIZUMAB ON CHOROIDAL HYPOFLUORESCENCE BY INDOCYANINE GREEN ANGIOGRAPHY

Choroidal hypofluorescence has been reported beneath the photodynamic therapy (PDT) site in clinical studies. We evaluated the choroidal hypofluorescence after combined PDT with posterior subtenon injection of triamcinolone acetonide or PDT with an intravitreal injection of bevacizumab for age-related macular degeneration. Two hundred and forty-two eyes with a subfoveal choroidal neovascularization caused by age-related macular degeneration were studied. Ninety-two eyes underwent PDT alone, 90 eyes underwent PDT with sub-Tenon injection of triamcinolone acetonide, and 60 eyes underwent PDT with intravitreal injection of bevacizumab. Verteporfin-induced choroidal hypoperfusion was determined by indocyanine green angiograms. The intensity of the diffuse fluorescence within the PDT site away from the choroidal neovascularization lesion and from the normal retina just peripheral to the optic disk was measured by densitometry (Topcon IMAGEnet computer system, Topcon, Tokyo, Japan) in the indocyanine green angiogram images obtained at 10 minutes 3 months after the PDT. The ratio of the average brightness of the retina within the PDT area to that of the retina peripheral to the optic disk (irradiated/nonirradiated retinal brightness ratio) was calculated for each angiogram. The irradiated/nonirradiated retinal brightness ratio of the angiograms was 0.96 in the PDT-alone group, 0.85 in the sub-Tenon injection of triamcinolone acetonide-PDT group, and 0.89 in the intravitreal injection of bevacizumab-PDT group (Kruskal-Wallis H test, P < 0.05). The degree of choroidal hypofluorescence in the indocyanine green angiogram images 3 months after PDT in the sub-Tenon injection of triamcinolone acetonide and intravitreal injection of bevacizumab group was higher than that of PDT-alone group. Sub-Tenon injection of triamcinolone acetonide and intravitreal injection of bevacizumab can prolong the duration of the choroidal hypofluorescence after PDT.

Subconjunctival Mycetoma After Sub-Tenon's Corticosteroid Injection

To describe a case of a subconjunctival mycetoma that developed after a patient received a sub-Tenon's injection of triamcinolone acetonide. Case report. A 76-year-old white male presented with a subconjunctival mass in the area of a previous posterior sub-Tenon's corticosteroid injection for wet age-related macular degeneration. Microbiologic and pathologic analysis of the mass revealed the causative organism to be the pigmented fungus Exophiala jeanselmei. This is the first published case of an Exophiala-associated subconjunctival mycetoma.

Systemic Absorption of Triamcinolone Acetonide after Posterior Sub-Tenon Injection

To study systemic absorption of triamcinolone acetonide (TA) after posterior sub-Tenon injection. Prospective, interventional case series. The study was conducted in a tertiary care teaching hospital on 35 eyes in which posterior sub-Tenon injection of 40 mg TA was administered after conventional extracapsular cataract extraction. Patients who had received any systemic steroid over 6 weeks preceding the period of study or had inflammatory ocular conditions were excluded. Serum TA levels were estimated by high-performance liquid chromatography at 1, 2, 3, 24, and 48 hours and 1, 2, and 6 weeks after injection. Significant levels of the drug were detected in 45.71% of samples (mean serum levels, 6.94 +/- 8.98 ng/ml; P < .001) at 1 hour after sub-Tenon injection, in 85.71% of samples (mean serum levels, 21.83 +/- 12.92 ng/ml; P < .001) at 2 hours after injection, in 100% of samples (mean serum levels, 47.14 +/- 12.20 ng/ml; P < .001) at 3 hours after injection, in 100% of samples (mean serum levels, 35.49 +/- 13.79 ng/ml; P < .001) at 24 hours after injection, in 62.86% of samples (mean serum levels, 10.46 +/- 10.69 ng/ml; P < .001) at 48 hours after injection, and in 28.57% of samples (mean serum levels, 3.74 +/- 6.45 ng/ml; P = .002) at 1 week after injection. The drug was not detected in any of the samples obtained 2 weeks and 6 weeks later. Posterior sub-Tenon injection of 40 mg TA adds statistically significant quantities to physiologic concentration of corticosteroids in peripheral blood. This may be detrimental for patients having certain metabolic diseases like diabetes and preferably should be avoided or administered with caution.

Complications and Safety Profile of Posterior Subtenon Injection of Triamcinolone Acetonide

Posterior subtenon injection (PSTI) of triamcinolone acetonide (TA) is one of the delivery methods for the treatment of posterior uveitis, diabetic macular edema, and cystoid macular edema secondary to retinal vein occlusions. The aim of this investigation was to assess the rates of various complications associated with PSTI and to determine which factors are associated with the development of complications. This investigation was a retrospective interventional case series, and one retinal specialist from 2005 to 2007 conducted all of the procedures. Patients were followed up for a mean time of 11.9 +/- 5.4 months after receiving 40 mg (1.0 mL) of nonfiltered TA and all complications associated with the injection procedure or with TA itself were noted. A total of 159 eyes in 158 patients were treated by PSTI of TA. Of 159 eyes, 145 eyes (91.2%) were injected once, 13 eyes (8.2%) were injected twice, and one eye (0.6%) was injected three times. The mean age of the 158 patients was 61.6 +/- 9.5 years. Eighteen eyes (11.3%) required glaucoma medication due to increased intraocular pressure (IOP) after injection. In addition, cataracts in three eyes (2.1%) progressed with biomicroscopic findings, as compared with the fellow eyes. There were no cases of mechanical injury, infection or ulceration of any part of eye, and eyelid complications. A conjunctival cyst at the injection site developed in one eye. In this study, PSTI of TA resulted in no severe complications such as endophthalmitis or retinal detachment, and a relatively less risk of IOP complications and cataract progression. PSTI of TA is an extremely safe procedure and can be repeatedly applied to an eye.

Systemic complications of posterior subtenon injection of triamcinolone acetonide in type 2 diabetes patients

We evaluated the influence of posterior subtenon injection of triamcinolone acetonide on blood glucose and blood pressure in type 2 diabetes patients. This treatment, in this limited series, did not significantly increase HbA1c levels or blood pressures. But spike-like increases of fasting blood glucose were observed in some cases.

Erratum to: Posterior Sub-Tenon Injection of Triamcinolone Acetonide as Pretreatment for Focal Laser Photocoagulation in Diabetic Macular Edema Patients

Erratum to: Posterior Sub-Tenon Injection of Triamcinolone Acetonide as Pretreatment for Focal Laser Photocoagulation in Diabetic Macular Edema Patients

Efficacy and complications of intravitreal injection of triamcinolone acetonide for refractory cystoid macular edema associated with intraocular inflammation

To assess the effects and complications of intravitreal injection of triamcinolone acetonide (IVTA) for posterior sub-Tenon injection of triamcinolone acetonide (PSTA)-resistant cystoid macular edema (CME) with intraocular inflammation. Medical records of eight eyes of six patients with PSTA-resistant CME were retrospectively examined. Each eye received a 4-mg IVTA, and an additional injection was performed when CME recurred. Visual acuity as logarithm of the minimum angle of resolution (logMAR), intraocular pressure (IOP), and central macular thickness (CMT) were assessed before and after each treatment. CME improved in six eyes (75%) with mean visual acuity recovering from 0.56+/-0.29 to 0.41+/-0.195 (logMAR, P=0.13) and mean CMT decreasing from 470 microm (range, 275-660 microm) to 297 microm (range, 150-697 microm) (P=0.04) 2 months after the initial IVTA. CME recurred an average of 9 months (range, 5-11 months) after IVTA. A higher dose (16-mg) IVTA was effective for two eyes refractory to repeated 4-mg IVTA. IOP was elevated in two eyes (25%), of which one required filtration surgery (12.5%). In phakic eyes, cataracts progressed and necessitated surgery. IVTA is effective for PSTA-resistant CME with intraocular inflammation, and its efficacy might be dose dependent.

Posterior sub-Tenon injection of triamcinolone acetonide as pretreatment for focal laser photocoagulation in diabetic macular edema patients

To determine whether a posterior sub-Tenon injection of triamcinolone acetonide (TA) before focal photocoagulation is safe and effective in patients with diabetic macular edema. Sixteen eyes of 11 diabetic patients with unresolved diffuse macular edema were treated with a 20-mg sub-Tenon injection of TA 1 to 2 months before focal photocoagulation. Focal photocoagulation was applied only to microaneurysms, and grid laser photocoagulation was not performed. The main outcome measures used were visual acuity (VA), central macular thickness (CMT) determined by optical coherence tomography (OCT), and the fluorescein angiographic appearance of the retina. Patients were followed for at least 6 months. One month after the sub-Tenon injection of TA, the macular edema was resolved with a significant reduction of the CMT on OCT. VA improved slightly. Subsequent focal photocoagulation of the microaneurysms maintained the significant reduction of CMT for up to 6 months. A significant improvement of VA was observed in 37.5% patients at 6 months, and there was no decrease in VA in any of the patients. A 20-mg sub-Tenon TA injection prior to focal laser photocoagulation is a safe and beneficial treatment in patients with diabetic macular edema.

Effect of a single intraoperative sub-Tenon injection of triamcinolone acetonide on the progression of diabetic retinopathy and visual outcomes after cataract surgery

To assess the effect of a single intraoperative sub-Tenon injection of triamcinolone acetonide on the progression of diabetic retinopathy (DR), visual outcomes, and cystoid macular edema (CME) after cataract surgery. Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea. This prospective controlled study comprised 46 eyes of 23 diabetic patients. The control group comprised eyes not treated with a triamcinolone acetonide injection, and the triamcinolone group comprised contralateral eyes treated with a single posterior sub-Tenon injection of triamcinolone acetonide at the end of cataract surgery. The visual acuity, central macular thickness (CMT) by optical coherence tomography, and progression of DR were compared between the 2 groups. One month postoperatively, the mean change in lines of best corrected visual acuity was significantly greater in the triamcinolone group (P = .045) and the mean change in CMT was significantly greater in the control group (P = .015). The incidence of CME was higher in the control group (P = 0.04). Scores for progression of DR at 6 months were not statistically significantly different between the 2 groups (P = 0.08). A posterior sub-Tenon injection of triamcinolone acetonide lowered the incidence of CME after cataract surgery in diabetic patients, improved visual recovery, and reduced the amount of CMT increase in the short term (< or = 1 month postoperatively). However, triamcinolone acetonide did not affect DR progression over the 6-month follow-up.

Intracameral triamcinolone acetonide to control postoperative inflammation following cataract surgery with phacoemulsification

To explore the efficacy, safety and tolerability of 1 mg intracameral triamcinolone acetonide (TA) in controlling ocular inflammation in patients undergoing cataract surgery. Sixty eyes of 60 patients undergoing cataract extraction with phacoemulsification at the Department of Ophthalmology, Baskent University School of Medicine were randomized into two groups. After surgery, eyes in group A were injected with 1 mg/0.1 ml TA into the anterior chamber, but eyes in group B were not. Postoperatively; in group B, topical prednisolone acetate 1% eyedrops were administered six times per day for 7 days, then four times per day for 15 days, to control postoperative inflammation. In group A, topical corticosteroids were not used. To evaluate the efficacy of intracameral TA, anterior chamber cells, anterior chamber flare and conjunctival hyperaemia were measured on postoperative days 1, 7 and 30 by slit-lamp biomicroscopy. The safety of intracameral TA was evaluated by visual acuity measurements, intraocular pressure values and fundus examination. Tolerance variables were assessed by the degree of burning, stinging and blurred vision. Both treatments were equally effective in controlling postoperative inflammation following phacoemulsification. No statistically significant differences between groups were observed for the efficacy, safety and tolerance variables, and no serious adverse events were observed. Intracameral TA of 1 mg can effectively be used to control postoperative inflammation after uncomplicated cataract surgery with phacoemulsification. This makes it possible to decrease the dosage and duration of topical prednisolone acetate.

Photodynamic therapy combined with posterior subtenon triamcinolone acetonide injection in the treatment of choroidal neovascularization

To evaluate the therapeutic effect of photodynamic therapy (PDT) combined with posterior subtenon injection of triamcinolone acetonide (PSTA) in the treatment of choroidal neovascularization (CNV). In this retrospective case-control study, treatment outcomes at 12 months of patients with CNV were reviewed. One hundred and two consecutive patients (102 eyes) with subfoveal CNV of various causes were included. Patients in the study group (n=46) received PDT followed within 2 days by 40 mg of PSTA. Patients in the control group (n=56) received PDT alone. Patients were retreated 3 months later or more if fluorescein angiography showed residual membrane leakage. Treatment outcomes were compared between the two groups and among different CNV subgroups. Gain in mean best-corrected visual acuity (BCVA) was significantly higher in the study group (+0.78 lines) than in the control group (-1.86 lines) (P<0.0001). The number of treatments within 1 year was significantly less in the study group (1.26 vs 1.63, P=0.008). The mean BCVA change for myopic CNV and age-related predominantly classic CNV subgroups was significantly higher in the study group (+2.82 vs -0.91 lines, P=0.0005 for myopic CNV; +0.6 vs -1.79 lines, P=0.01 for age-related predominantly classic CNV). The main side effect in the study group was increased intraocular pressure (8.7%). Compared with PDT alone, PDT combined with PSTA has a better therapeutic effect for both myopic and age-related predominantly classic CNV; the myopic CNV subgroup shows the best response.

Intraocular pressure elevation after intravitreal or posterior sub-Tenon triamcinolone acetonide injection

Background: Despite the benefits of intraocular steroids for the treatment of inflammatory, neovascular, proliferative, and edematous diseases, one of the side effects is raised intraocular pressure (IOP). In this study, we attempted to identify when IOP elevates, peaks, and returns to the preinjection baseline IOP after intravitreal or posterior sub-Tenon administration of triamcinolone acetonide, as well as the factors that might affect IOP Methods: Retrospective case review was undertaken of 69 patients (82 eyes), who received either a 4 mg intravitreal (16 eyes) or a 20 mg posterior sub-Tenon (66 eyes) triamcinolone acetonide injection. IOP assessment for each eye was completed at the preinjection baseline and at the first, third, and sixth month of follow-up. Results: The mean IOP of all eyes increased significantly at each follow-up.The mean maximum elevation ratio from the baseline was 4.0 (SD 5.2) mm Hg. An elevation of 5 mm Hg or greater occurred in 28 eyes (34.1%).The maximum elevation correlated significantly with age ( p < 0.01).The incidence of an elevation of 5 mm Hg or greater was significantly higher among patients younger than 60 years ( p < 0.01) and relatively higher among female patients ( p = 0.051). The mean IOP increased significantly at the first month after intravitreal injection but at all follow-up periods after posterior sub-Tenon injection. There was no significant difference in IOP elevation according to disease type, although eyes with diabetic retinopathy tended to be at higher risk of IOP elevation. Two eyes of two female patients, who had received posterior sub-Tenon injections for the treatment of diabetic retinopathy, required glaucoma surgery. Interpretation: The IOP elevation of 5 mm Hg or greater observed in 34.1% of the eyes was consistent with past reports. IOP elevation was associated with patients of less than 60 years of age and with female sex, and it lasted longer after posterior sub-Tenon injection than after intravitreal injection. Careful assessment of IOP during a follow-up period of at least 6 months is paramount, especially in younger female patients after posterior sub-Tenon injection.