National survey of the technique of intravitreal triamcinolone injection in the United Kingdom

Abstract

Objectives: Intravitreal injection of steroids is a rapidly evolving treatment option for a variety of retinal pathologies. There is wide variation among ophthalmologists regarding dose of steroid and the technique of injection. Through this survey we aim to describe the current practice of injection of intravitreal steroid among ophthalmic consultants in the United Kingdom and review the literature. Methods: Apostal questionnaire was sent to all the 901 ophthalmic consultants in the United Kingdom. The questions covered frequency of intravitreal steroid injections, subspecialty interest, dosage and volume of steroid, patient preparation, surgeon preparation, and postoperative management. Results: The response rate to the questionnaire was 63%. A total of 24.7% perform intravitreal steroid injections regularly with 90% of users performing five or fewer injections per month. In all, 94% use a dose of 4 mg. Among surgeons, 38% do not prescribe postoperative antibiotics or steroids and 59% check intraocular pressure either on the same or the next day. Conclusion: The relatively short experience with this technique has not yet allowed a clear picture to emerge of indications, complications or best practice administration. Published descriptions of intravitreal steroid injection techniques vary widely and variations are not evidence based. Observed UK practice is diverse.