PURPOSE: To evaluate the changes of anterior chamber parameters and intraocular pressure (IOP) with Pentacam(R) after intravitreal injection. METHODS: A total of 76 eyes of 76 patients received an intravitreal injection of either triamcinolone acetonide (TA) or bevacizumab. Twelve patients were treated with an intravitreal injection of TA 0.1 ml, 16 patients were treated with an intravitreal injection of TA 0.05 ml, while the remaining 48 patients received a bevacizumab 0.05 ml injection. All patients underwent anterior chamber depth, anterior chamber angle, and anterior chamber volume evaluation with Pentacam(R) before and 5 minutes after injection. Additionally, IOP measurements were taken 5 minutes before and 5 minutes, 30 minutes, 1 hour and 1 day after injection. RESULTS: Anterior chamber depth, anterior chamber angle, anterior chamber volume, and IOP changes in patients receiving TA 0.1 ml were 0.4 +/- 0.11 mm, 10.2 +/- 4.1degrees, 33.7 +/- 5.9 mm3 and 18.8 +/- 12.1 mm Hg, respectively. Anterior chamber depth, anterior chamber angle, anterior chamber volume, and IOP changes in patients receiving TA 0.05 ml were -0.01 +/- 0.05 mm, 2.4 +/- 3.2degrees, 5.8 +/- 9.5 mm3 and 4.8 +/- 7.4 mm Hg, respectively. Anterior chamber depth, anterior chamber angle, anterior chamber volume, and IOP changes in patients receiving bevacizumab were 0.28 +/- 0.99 mm, 0.8 +/- 4.0degrees, 7.1 +/- 9.6 mm3 and 5.4 +/- 6.3 mm Hg, respectively. There was a significant difference between TA 0.1 ml and 0.05 ml. However, there was no significant difference between TA 0.05 ml and bevacizumab 0.05 ml. CONCLUSIONS: Because of similar anterior chamber parameters changes after 0.05 ml intravitreal injection with TA or bevacizumab, early period IOP increases due to intravitreal volume expansion. Intravitreal 0.05 ml injections do not require any other procedures for controlling IOP 30 minutes after injection.
Anterior Chamber* ; Humans ; Intraocular Pressure ; Intravitreal Injections* ; Triamcinolone Acetonide ; Bevacizumab

Effect of Ouabain administration on aqueous humor dynamics were studied in albino rabbits. Intravenous injection of 0.1 mg/kg of ouabain in 10 rabbits produced significant reduction of intraocular pressure. The highest lowering of intraocular pressure occurred 70 minutes after the injection, its magnitude being 35.54% of the original pressure. The intraocular pressure returned to its original pressure 117.0 minutes after the injection. Perilimbal suction cup studies revealed 26.92 % reduction in aqueous flow. Intravitreal injection of O.1 micro gram of ouabain dissolved in 0.02 ml performed in 5 rabbits' eyes produced marked lowering of intraocular pressure. The maximum tension lowering effect (60.15%) was observed 4.6 days after the administration, and the tension recovered 15.8 days after the injection. Perilimbal suction cup studies showed 29.48 % reduction in aqueous flow. It is concluded that Na-K ATPase play an important role in the aqueous formation and that ouabain lowers the intraocular pressure by supressing this enzyme. Intravitreal administration has more powerful tension-lowering effect than intravenous injection.
Adenosine Triphosphatases ; Aqueous Humor ; Injections, Intravenous ; Intraocular Pressure* ; Intravitreal Injections ; Ouabain* ; Rabbits* ; Suction

Endophthalmitis is one of the most catastrophic complications in intraocular surgery and penetrating injuries of the eye and intraocular injection of gentamicin is frequently used for its treatment. But the use of gentamicn resulted in sight-limiting complication such as cataract and the increased calcium level in the lens is an important factor of cataractogenesls. In this experiment, Ca++ - achivated ATPase activity, active Ca++ efflux and calcium concentration in the lens were measured at day 1, day 3 and 7 days after injection of gentamicin into the anterior chamber or vitreous to compare the effect on calcium transport in the rabbit lenses according to the route of administration. Ca++ -activated ATPase activity was progressively inhibited, active efflux of Ca++ was significantly decreased and calcium concentration progressively increased. So, it may be speculated that the decreased active efflux of Ca++ from the lens is related to inhibiting Ca++ -activated ATPase activity and this makes the accumulation of calcium in the lens. These effects were more severe in the intravitreal injection than in the intracameral injection group.
Adenosine Triphosphatases ; Anterior Chamber ; Calcium* ; Cataract ; Endophthalmitis ; Gentamicins* ; Injections, Intraocular ; Intravitreal Injections

Endophthalmitis is one of the most catastrophic complications in intraocular surgery and penetrating injuries of the eye and intraocular injection of gentamicin is frequently used for its treatment. But the use of gentamicn resulted in sight-limiting complication such as cataract and the increased calcium level in the lens is an important factor of cataractogenesls. In this experiment, Ca++ - achivated ATPase activity, active Ca++ efflux and calcium concentration in the lens were measured at day 1, day 3 and 7 days after injection of gentamicin into the anterior chamber or vitreous to compare the effect on calcium transport in the rabbit lenses according to the route of administration. Ca++ -activated ATPase activity was progressively inhibited, active efflux of Ca++ was significantly decreased and calcium concentration progressively increased. So, it may be speculated that the decreased active efflux of Ca++ from the lens is related to inhibiting Ca++ -activated ATPase activity and this makes the accumulation of calcium in the lens. These effects were more severe in the intravitreal injection than in the intracameral injection group.
Adenosine Triphosphatases ; Anterior Chamber ; Calcium* ; Cataract ; Endophthalmitis ; Gentamicins* ; Injections, Intraocular ; Intravitreal Injections

PURPOSE: The present study investigates the onset and frequency of increased intraocular pressure (IOP) after injections of intravitreal Bevacizumab, Triamcinolone, and a combination of both drugs. METHODS: Patients were classified into three groups: Bevacizumab group (group A), Triamcinolone group (group B), and combined drug group (group C), irrespective of the underlying causes. The IOP was measured 30 minutes prior to followed by one day, one week, one month, two months, three months, six months, and one year after injection. The measured IOP at each time point was compared with the pre-injection IOP and the differences in IOP among the three groups were statistically analyzed. The relationships between various factors possible of increasing IOP were also analyzed. RESULTS: A total of 259 subjects were enrolled in the present study. An IOP increase of more than 5 mm Hg was observed in 25 eyes (15%) in group A, 34 eyes (40%) in group B, and 40 eyes (50%) in group C. There was no statistically significant mean IOP change after injection in group A, but in groups B and C there was an increase in mean IOP up until two and three months after injection, respectively. However, eyes in group A with a history of glaucoma showed statistically significant increases in IOP. CONCLUSIONS: The onsets and frequencies of increased IOP were different with the different drugs. Proper follow-up for increased IOP after injection is necessary based on the type of drug used.
Antibodies, Monoclonal, Humanized ; Eye ; Follow-Up Studies ; Glaucoma ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Triamcinolone ; Bevacizumab

PURPOSE: The purpose of the present study was to investigate the prophylactic effects of a fixed combination of dorsolamide/timolol on intraocular pressure (IOP) elevation before intravitreal anti-VEGF injection. METHODS: A prospective, randomized clinical trial was conducted on 91 eyes of 91 patients undergoing intravitreal anti-VEGF injection. The eyes were randomly divided into 2 groups, the eyes which had used the fixed prophylactic dorsolamide/timolol combination (group 1, 58 eyes) and the eyes which had not used the combination (group 2, 15 eyes). The IOP was measured one hour and 5 minutes prior to the procedure, 5 minutes interval up to 30 minutes after the procedure and one hour, 1 day, 7 days, and one month after the procedure. The IOP changes were analyzed. RESULTS: The mean 5 minutes and 30 minutes postoperative IOPs were 14.12 +/- 4.18 mm Hg and 10.87 +/- 1.58 mm Hg in group 1 and 28.21 +/- 3.16 mm Hg and 17.48 +/- 2.34 mm Hg in group 2, respectively. After IVBI, the mean 5 min postoperative IOP was 12.17 +/- 1.13 mm Hg in group 1 and 27.12 +/- 3.35 mm Hg in group 2. After IVRI, the mean 5 minutes postoperative IOP was 15.98 +/- 4.14 mm Hg in group 1 and 25.19 +/- 1.04 mm Hg in group 2. CONCLUSIONS: Prophylactic use of a fixed dorsolamide/timolol combination before intravitreal anti-VEGF injection is an easy and safe method of preventing IOP elevation immediately after intravitreal injection of bevacizumab or ranibizumab.
Antibodies, Monoclonal, Humanized ; Eye ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Prospective Studies ; Timolol ; Bevacizumab ; Ranibizumab

PURPOSE: This study evaluated the safety and efficacy of crystalline triamcinolone acetonide (TA) in pars plana vitrectomy for proliferative diabetic retinopathy. METHODS: A total of 152 eyes of 143 patients were enrolled in the study, and divided into 3 groups: Group I underwent pars plana vitrectomy without intravitreal injection of TA, group II underwent TA-assisted vitrectomy, and group III underwent TA-assisted vitrectomy and received an intravitreal injection of 4 mg TA at the end of surgery. RESULTS: In Groups I, II and III, 31 eyes (62.0%), 35 eyes (67.3%), and 41 eyes (82.0%), respectively, showed frequency of gain in visual acuity, group III showed greater improvements in vision after surgery than group I; the difference was statistically significant. Four eyes (8.0%) in group I, 12 eyes (23.1%) in group II, and 12 eyes (24.0%) in group III had an intraocular pressure higher than 21 mmHg after the operation; there were statistically significant differences in groups II and III compared to group I (P=0.04, P=0.03, respectively). Ten eyes (20.0%) in group I, 3 eyes (5.8%) in group II, and 3 eyes (6.0%) in group III needed additional surgery. Groups II and III, which received TA-assisted vitrectomy, had lower incidences of re-operation than group I (P=0.03, P=0.04, respectively). CONCLUSIONS: Triamcinolone acetonide-assisted vitrectomy appears to be a potentially useful way to reduce the incidence of re-operation and an intravitreal injection of TA at the end of surgery may be useful for improving postoperative visual acuity.
Crystallins ; Diabetic Retinopathy* ; Humans ; Incidence ; Intraocular Pressure ; Intravitreal Injections ; Triamcinolone Acetonide* ; Triamcinolone* ; Visual Acuity ; Vitrectomy*

PURPOSE: To evaluate the safety of posterior subtenon's injection of triamcinolone acetonide (PSTA) after intravitreal triamcinolone acetonide injection (IVTA). METHODS: We reviewed the charts of 34 patients who had previously treated with IVTA. Patients were categorized as steroid responder or non-responder. Responders were defined as having a relative intraocular pressure increase of 5 mmHg and absolute intraocular pressure greater than 24 mmHg. Relative risk of intraocular pressure was prospectively evaluated after PSTA. RESULT: Eighteen eyes were categorized as steroid responders after IVTA injection and sixteen eyes were categorized as non-responders. For the actual amount of increase in the intraocular pressures, the steroid responder group (39%) was shown to be statistically higher than the non-responder group (6%) (P=0.044). However, the mean pressure values did not show a significant difference (P>0.05). Only one eye required the use of glaucoma medications and the intraocular pressure remained normal after treatment. CONCLUSIONS: PSTA is a relatively safe treatment method after IVTA injection regardless of steroid responsiveness.
Eye ; Glaucoma ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Prospective Studies ; Triamcinolone ; Triamcinolone Acetonide

PURPOSE: To retrospectively evaluate the clinical effect of intravitreal (IVT) and posterior subtenon (PSTT) triamcinolone acetonide (TA) injection in diabetic macular edema. METHODS: Fifty eyes of 43 patients with diabetic macular edema (DME) were included. Twenty-two eyes in the IVT group received 4 mg/0.1 ml intravitreal TA injections and 26 eyes in the PSTT group received 40 mg/1.0 ml subtenon TA injections. LogMAR visual acuity and intraocular pressure (IOP) were measured and, using OCT, central macular thickness (CMT) and total macular volume (TMV) were also measured before and 1, 3, and 6 months postoperatively. RESULTS: Both groups showed significant decreases in the mean CMT and TMV. The mean CMT in the IVT group was significantly thinner than that of the PSTT group 1 month postoperatively. The percentage reduction in CMT and TMV were also greater in the IVT group than the PSTT group 1 month postoperatively. Both groups showed significant improvements in mean visual acuity, with no significant difference between the two groups. However, at 1-month postoperative improvement in visual acuity was significantly greater in the IVT group than the PSTT group. The mean IOP in the IVT group was also greater than that in the PSTT 1 month postoperatively. CONCLUSIONS: Both injections caused a significant increase in visual acuity and a decrease in CMT and TMV. The effect was more pronounced in the IVT group. However, the PSTT injection also appeared to be a safe and effective technique for the treatment of DME.
Eye ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Macular Edema ; Retrospective Studies ; Triamcinolone ; Triamcinolone Acetonide ; Visual Acuity

PURPOSE: To evaluate the efficacy and safety of the combination of cataract surgery and intravitreal bevacizumab injection in patients with cataract and diabetic macular edema. METHODS: Patients received an intravitreal injection of bevacizumab(1.25 mg) combined with phacoemulsification and implantation of a posterior chamber intraocular lens. Best corrected visual acuity (BCVA, LogMAR) and, central macular thickness (CMT) were measured using OCT at baseline and at one week, one, three, and six months after surgery, and adverse events were recorded. RESULTS: The mean baseline LogMAR BCVA was 0.84+/-0.50 and mean CMT was 337.1+/-57.50 micrometer. At one week, one, three, and six months after surgery, the mean BCVAs were 0.52+/-0.40, 0.51+/-0.42, 0.52+/-0.34, and 0.46+/-0.37, and the mean CMTs were 356.4+/-86.44 micrometer, 338.8+/-138.4 micrometer, 349.0+/-122.9 micrometer, and 334.2+/-100.4 micrometer, respectively. No adverse events associated with cataract surgery or intravitreal bevacizumab injection were observed. CONCLUSIONS: The short-term results from the present study suggest the combination of cataract surgery and intravitreal bevacizumab injection are safe and effective for the prevention of macular edema aggravation for one month, but has little effect on prevention of macular edema aggravation three months after surgery for diabetic macular edema patients.
Antibodies, Monoclonal, Humanized ; Cataract ; Humans ; Intravitreal Injections ; Lenses, Intraocular ; Macular Edema ; Phacoemulsification ; Visual Acuity ; Bevacizumab