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: To compare the effect and complications of treatments for diabetic macular edema. METHODS: Literature review using the Korean medical database and the Korean Ophthalmological Society database was performed. Studies used consisted of patients with diabetic macular edema, comparing intravitreal triamcinolone acetonide (IVTA) injection with posterior subtenon triamcinolone acetonide (STTA) injection or intravitreal bevacizumab (IVB) injection, according to visual acuity (VA) outcomes, central macular thickness (CMT), and intraocular pressure (IOP) at 1, 3, and 6 months. RESULTS: In the three studies comparing IVTA injection with STTA injection, IVTA injection demonstrated greater improvement in VA at 1 month and CMT at 6 months. The patients who received IVTA injection had significantly higher IOP at 3 months. In the three studies comparing IVTA injection with IVB injection, IVTA injection demonstrated greater improvement in VA at 3 months and CMT at 6 months. CONCLUSIONS: The functional and anatomical improvements are achieved by IVTA injection, STTA injection, and IVB injection for diabetic macular edema, and the effect of IVTA injection is more prominent than other injection types with longer duration.
Antibodies, Monoclonal, Humanized ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Macular Edema ; Triamcinolone Acetonide ; Visual Acuity ; Bevacizumab

PURPOSE: To investigate the efficacy of anterior chamber paracentesis in intravitreal triamcinolone acetonide injection (IVTA). METHODS: A prospective, randomized clinical trial was conducted on 30 eyes of 30 patients undergoing IVTA. Eyes were randomly divided into two groups, those which had undergone anterior chamber paracentesis (Group 1, 15 eyes) and those which had not (Group 2, 15 eyes). We analyzed postoperative changes in intraocular pressure (IOP) in each group. RESULTS: In group 1, the mean preoperative IOP was 15.33+/-1.72 mmHg; postoperative IOP at 2 and 15 minutes was 7.80+/-1.47 and 11.73+/-1.67 mmHg, respectively. In group 2, there was significant elevation of IOP (46.73+/-8.26 mmHg) 2 minutes after the injection, although this was reduced to the normal range (16.13+/-2.61 mmHg) within 15 minutes. CONCLUSIONS: Routine anterior chamber paracentesis seems to be inappropriate considering the brief elevation in IOP that immediately follows IVTA.
Anterior Chamber* ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Paracentesis* ; Prospective Studies ; Reference Values ; Triamcinolone Acetonide ; Triamcinolone*

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

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 compare intraocular pressure (IOP) changes after intravitreal triamcinolone acetonide versus bevacizumab injection. METHODS: IOP was measured in 40 patients who received an intravitreal injection of 0.1 ml triamcinolone and 40 patients who received 2 consecutive intravitreal injections of bevacizumab (0.05 ml and 0.1 ml). Patients were divided into three groups : 0.1 ml triamcinolone group (0.1 IVTA group), 0.05 ml bevacizumab group (0.05 IVB group), and 0.1 ml bevacizumab group (0.1 IVB group). IOPs were compared within groups at different time points (before, 1 day after, and 30 days after the injection) and between groups at the same time points. RESULTS: In the 0.05 IVB and 0.1 IVB groups, IOP at 1 day after injection was significantly lower than before injection (P< 0.01, P = 0.03), and IOP at 30 days after injection was significantly higher than IOP at 1 day after injection (P < 0.01, P < 0.01). In the 0.1 IVTA group, IOP at 30 days after injection was significantly higher than before injection (P = 0.01). Between groups, IOP at 1 day after injection in the 0.05 IVB group was significantly lower than IOP in the 0.1 IVTA group (P = 0.03). CONCLUSIONS: IOP was decreased at 1 day after intravitreal bevacizumab injection, whereas in intravitreal triamcinolone acetonide IOP elevation persisted after 1 month.
Antibodies, Monoclonal, Humanized ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Triamcinolone ; Triamcinolone Acetonide ; Bevacizumab