Intravitreal triamcinolone acetonide (IVTA) is associated with which MOST clinically significant local complication when used for diabetic macular edema?

• A Cystoid macular edema worsening
• B Optic nerve atrophy from direct toxicity
• C Proliferative vitreoretinopathy induction
• D Steroid-induced glaucoma and acceleration of cataract formation ✓

Explanation

Steroid-induced ocular hypertension (developing in ~30-40% of patients) with risk of glaucomatous damage, and posterior subcapsular cataract acceleration, are the most clinically significant local complications of intravitreal triamcinolone. IOP elevation typically occurs 4–6 weeks after injection and may require anti-glaucoma medication or, rarely, surgical intervention. This steroid response profile is also seen with intravitreal dexamethasone implant (Ozurdex) and fluocinolone acetonide implant (Iluvien), though with different kinetics. These complications are a major reason anti-VEGF agents have become first-line for centre-involving DME.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.