Effect of Suprachoroidal Triamcinolone on Intraocular Pressure: a Systematic Review and Meta-Analysis

Background: Triamcinolone acetonide is a synthetic corticosteroid with multiple ocular uses. Like other corticosteroids, it too is associated with ocular side effects such as increased intraocular pressure (IOP), glaucoma and cataracts. Suprachoroidal administration of triamcinolone is hoped to reduce the ocular side effects of the drug, especially rises in IOP. Our systematic review and meta-analysis aims to study this phenomenon. Objectives: The purpose of this study was to evaluate the effect of suprachoroidal triamcinolone injections on IOP. Design: Systematic review and meta-analysis Methods: We utilized the Medline, Scopus and Cochrane databases for this review. Studies published till June 2023, which fulfilled the eligibility criteria, were included. Studies in the English language with adult participants who were administered suprachoroidal triamcinolone without any concurrent intervention were included, whereas studies that did not report the mean and standard deviation for IOP were excluded. The outcome of interest was IOP at 1, 3 and 6 months post-suprachoroidal triamcinolone injection. IOP values from included studies were extracted onto Review Manager version 5.4 for analysis. Results: Our search yielded 104 results, from which 22 papers were shortlisted for full-text screening. Finally, 12 studies were included in the analysis. Our analysis suggests a statistically significant increase in IOP in the first month after suprachoroidal triamcinolone injection but no significant differences at 3 and 6 months post-injection as compared to baseline. Conclusion: Elevated IOP at 1 month post-injection must be considered when using suprachoroidal triamcinolone and adequate safety measures must be taken. However, the absence of a significant rise at 3 and 6 months post-injection indicates that this modality is safer than other existing drug delivery methods. Trial registration: Registered with the Research Registry with the unique identifying number ‘reviewregistry1656.’ https://www.researchregistry.com/browse-the-registry#registryofsystematicreviewsmeta-analyses/registryofsystematicreviewsmeta-analysesdetails/648eefe65b6523002995eb21/