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Kamden R. Kopani, Nicholas J. Butler, Alexandre de Saint Sardos, Eric B. Suhler; Intravitreal Triamcinolone Acetonide in the Treatment of Uveitic Cystoid Macular Edema: A Comparison of 1mg, 2mg and 4mg doses. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4265.
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To compare the efficacy and safety of 1mg vs. 2mg vs. 4mg intravitreal triamcinolone acetonide (IVTA) in the treatment of cystoid macular edema (CME) secondary to non-infectious uveitis.
A retrospective review of all patients requiring IVTA for uveitic CME at our institution since January 1, 2010 was performed. Changes in best corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure (IOP), and cataract status were compared between the two treatment groups, from the baseline visit to one month post injection.
5 eyes (3 patients) received 1mg, 6 eyes (5 patients) received 2mg, and 9 eyes (7 patients) received 4mg IVTA. CMT decreased in all groups, from 540+/-26µm to 352+/-21µ (70% standardized change in CMT) in the 1mg group, 619+/-114µ to 461+/-109µ (58% standardized change in CMT) in the 4mg group, and 512+/-164µ to 336+/-76µ (72% standardized change in CMT) in the 4mg group. The mean visual acuity also improved in all three groups, from LogMAR 0.45 +/- 0.12 (Snellen 20/56 +/- 1.2 lines) to 0.26 +/- 0.21 (20/37 +/- 2.1 lines) in the 1mg group, LogMAR 0.67 +/- 0.37 (Snellen 20/90 +/- 3.7 lines) to 0.44 +/- 0.32 (20/42 +/- 3.2 lines) in the 2mg group, and LogMAR 0.44 +/- 0.19 (Snellen 20/55 +/- 1.9 lines) to 0.39 +/- 0.2 (20/49 +/- 2 lines) in the 4mg group. None of the 1mg or 2mg treated eyes experienced an increase in IOP, while 4/9 (44%) receiving 4mg injections had pressure readings >21 at 1 month. Neither group demonstrated a progression in cataract status during the study period.
In the short term, there does not appear to be any difference in the efficacy of 1mg, 2mg or 4mg IVTA in the treatment of uveitic CME. The 4mg dose may have a greater ocular hypertensive effect.
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