Safety of intravitreal high-dose reinjections of triamcinolone acetonide

PURPOSE: To report side effects after intravitreal high-dose reinjections of triamcinolone acetonide. DESIGN: Clinical interventional case series. METHODS: Forty-six patients (47 eyes) received at least two intravitreal injections of approximately 20 to 25 mg triamcinolone acetonide for treatment of diabetic macular edema (n = 6 eyes), exudative age-related macular degeneration (n = 23), and other diseases. Intervals between injections were 6.7 +/- 3.4 months, 8.0 +/- 4.6 months, and 10.2 months, respectively, before the second (n = 47 eyes), third (n = 9), and fourth (n = 2) injection. Mean follow-up was 20.7 +/- 8.9 months. RESULTS: After no reinjection were complications detected, other than those known to occur after a single intravitreal injection. After the first, second, and third injection, respectively, intraocular pressure remained normal in 24 (51%), 25 (53%), and 5 (56%) eyes. CONCLUSIONS: Intravitreal high-dosage reinjections of triamcinolone acetonide may be tolerated within a mean follow-up of approximately 21 months.