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M Spirn, DB Roth, DL Yarian, SN Green, SR Leff, ES Friedman, BJ Keyser, HM Wheatley; Intravitreal Injection of Triamcinolone in the Treatment of Refractory Cystoid Maular Edema . Invest. Ophthalmol. Vis. Sci. 2002;43(13):501.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To study the effect of intravitreal injection of triamcinolone as treatment for chronic cystoid macular edema (CME) refractory to drops or periocular steroid injections. Method: Twenty nine eyes of 23 patients were treated. The visual acuity before treatment ranged from 20/40 to 20/400. All patients were evaluated with pre-treatment fluorecein angiography (FA). The degree of cystoid macular edema, as well as the amount of diffuse macular edema was graded on a scale of 0 to 4. The etiology of the CME was diabetic retinopathy in nineteen eyes, macular pucker in three eyes, postoperative CME in five eyes, central retinal vein occlusion in one eye, and idiopathic in one eye. Treatment consisted of a single intravitreal injection of 1 mg of triamcinolone under sterile conditions. A paracentesis was performed if the intraocular pressure was above 40 mm Hg after injection. Several patients required repeat trimacinolone injections over follow-up for persistent or recurrent leakage from CME on fluorescein angiography. Results: CME diminished or resolved completely in 26 (89.7%) of 29 eyes. Visual acuity improved by 2 or more lines of Snellen visual acuity in 6 (20.7%) eyes and remained the same in 23 (79.3%) eyes. None of the patients experienced visual loss over the initial follow-up period. Fourteen (48.3%) of the 29 eyes improved by one or more lines of Snellen visual acuity. Conclusion: Intravitreal injection of triamcinolone appears to be an effective treatment modality for refractory cystoid macular edema. Repeat injections may be necessary to address persistent or recurrent CME. The lasting effect of this treatment needs further study with longer follow-up.
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