Intravitreal triamcinolone for the treatment of cystoid macular oedema
Background: Longstanding cystoid macular oedema (CME) can result in loss of central vision, and there are only limited therapeutic possibilities. The aim of this article is to report clinical outcome of our patients with CME treated with intravitreal application of triamcinolone acetonide.
Methods: Prospective clinical interventional non-comparative case study of patients, treated for CME in 2004 in Eye Clinic of Ljubljana. There were 15 patients (16 eyes) in the 1–16 months follow-up study. Patients received an intravitreal injection of 4 mg (0,1 ml) triamcinolone acetonide transconjunctivally with topical anesthesia. The visual and anatomic responses were observed as well as related potentional complications.
Results: Causes of CME were: cataract surgery in 6 patients, branch retinal vein occlusion in 5 patients, uveitis in 2 patients, and diabetes and age related macular degeneration respectively in one patient. Age of patients was between 27 to 85 years, mean 69 years. Visual acuity before the treatment was from 0.017 to 0.6, mean 0.2. After the treatment visual acuity was from 0.017 to 1.0, mean 0.32. In patient series after cataract operation mean visual acuity before therapy was 0.12 and final 0.36, and in uveitis group 0.32 and final 0.42. In other CME forms there was insignificant visual improvement. In 2 patients (13%) increased intraocular preasure was found and treatment with topical ocular hypertensive agents was sufficient. In one patient progressive cataract was established, and in one patient retinal fibrosis in the macula and around thrombotic vein was found.
Conclusions: Intravitreal triamcinolone application is probably a good and safe therapeutic possibility for CME, the risk of serious adverse events considering good technique of injections is low. In our series of patients best results were found in patients after cataract surgery and uveitis. However, the observed series is too small to bring final conclusions.
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