Original scientific paper

https://doi.org/10.20471/acc.2022.61.04.08

Is a Decreased Nitric Oxide Concentration after Triamcinolone Acetonide Intravitreal Injection One of the Reasons for Intraocular Pressure Rise?

Nenad Petrović ; Department of Ophthalmology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia; Department of Ophthalmology, Kragujevac Clinical Center, Kragujevac, Serbia
Dušan Todorović ; Department of Ophthalmology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia; Department of Ophthalmology, Kragujevac Clinical Center, Kragujevac, Serbia
Sunčica Srećković ; Department of Ophthalmology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia; Department of Ophthalmology, Kragujevac Clinical Center, Kragujevac, Serbia
Svetlana Jovanović ; Department of Ophthalmology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia; Department of Ophthalmology, Kragujevac Clinical Center, Kragujevac, Serbia
Marija Petrović ; Department of Laboratory Diagnostics, Kragujevac Clinical Center, Kragujevac, Serbia
Ivan Stojadinović ; epartment of Orthopedic Surgery and Traumatology, Kragujevac Clinical Center, Kragujevac, Serbia
Tatjana Šarenac Vulović ; Department of Ophthalmology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia; Department of Ophthalmology, Kragujevac Clinical Center, Kragujevac, Serbia

Abstract

Diabetic macular edema is the most common cause of vision loss in patients affected
by diabetes mellitus. For eyes with persistent retinal thickening despite anti-VEGF therapy, treatment with
intravitreal triamcinolone may be considered, especially in pseudophakic eyes. The aim of this study was to
examine aqueous humor nitric oxide concentration changes in pseudophakic eyes with persistent diffuse
diabetic macular edema after intravitreal injection of triamcinolone acetonide, as well as the potential impact
of these changes on the intraocular pressure values. In 10 pseudophakic eyes with persistent diffuse diabetic
macular edema, paracentesis of anterior chamber with aspiration of aqueous humor and nitric oxide
concentration measurements were done on the day of the intravitreal application of 20 mg triamcinolone
acetonide, and after 1, 3, 6 and 9 months. Also, we were recording intraocular pressure values before the
intravitreal triamcinolone acetonide injection and during the next 9 months. One month after the intravitreal
triamcinolone acetonide injection, we noticed a decrease of nitric oxide concentration (45.37±5.55
μmol/L) by 31.79% compared to the initial values (66.52±7.66 μmol/L). After that, nitric oxide concentrations
began to rise slightly, and at the end of the ninth month the mean nitric oxide concentration was
similar to that recorded at the beginning of the study. Intraocular pressure values had increasing trend one
month after the intravitreal triamcinolone acetonide injection (23.70±4.08 mm Hg) compared to the initial
values (16.21±1.55 mm Hg), but after nine months these values returned to normal levels. Decreased
concentration of nitric oxide could be one of the reasons for increased intraocular pressure after intravitreal
application of triamcinolone acetonide in the treatment of diffuse diabetic macular edema.

Keywords

Diabetic macular edema; Intravitreal triamcinolone acetonide injection; Intraocular pressure; Nitric oxide

Hrčak ID:

301954

URI

https://hrcak.srce.hr/301954

Publication date:

1.12.2022.

Article data in other languages: croatian

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