Purchase this article with an account.
M. Pedroza-Seres, D. Gonzalez-Guajardo, M. Nuno-Suarez; Intravitreous Triamcinolone or Bevacizumab in Patients With Uveitis. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5862.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate our results in intravitreous triamcinolone and bevacizumab treatment in patients with uveítis.
Records of 451 patients with uveitis were analyzed. Fifty (62 eyes) patients were elected for intravitreous triamcinolone (IVT) or intravitreous bevacizumab (IVB). All the patients underwent a complete ophthalmological and paraclinical exams in order to obtain their definitive diagnosis of uveitis. IVT dosis was 4mg/0.1mL and IVB was 2.5mg/0.1mL. All the patients received antibiotical eye drops and were revised after 24 hours and 1, 3, weeks and 2, 3, 4 and 6 months. T test were used for the statistical analysis.
From 50 patients, 17 (34%) were male and 33 (66%) female. Age range was 9-79 years (mean 44). A total of 62 eyes were analyzed. IVT was used in 42 patients (51 eyes) and IVB was used in 10 patients (11 eyes). The main indication for the use of IVT was macular edema in 32 eyes (62.7%), refractory uveitis in 14 eyes (27.4%) and retinal serous detachment in 5 eyes (9.8%). The main indication for IVB was macular edema in 6 eyes (54%), peripheral retinal neovascularization in 3 eyes (27.2%) and neovascular membrane in 2 eyes (18%). Diagnosis of uveitis in patients whom received IVT were: Vogt-Koyanagi-Harada diseases 14 patients (33%), Idiophatic non-infectious panuveitis 6 patients (14%), anterior non-granulomatous HLA-B27+ uveitis 5 patients (12%), pars planitis and idiophatic retinal vasculitis 2 patients, and other less frequent diagnosis of uveitis. The diagnosis of uveitis in patients whom received IVB were idiopathic retinal vasculitis 2 eyes (18%), ocular toxoplamosis 2 eyes (18%), bowel inflammatory disease, retinal vasculitis secondary to tuberculosis, presuntive ocular histoplasmosis syndrome, antiphospholipid syndrome 1 eye (9% each). Visual acuity improved more than 2 lines in 38 eyes (90%) of patients injected with IVT (p <0.05) and 8 eyes (72.7%) of patients whom received IVB (p <0.05). Ocular hypertension was developed in 21 eyes (41%) of patients whom injected with IVT and 2 of them required valvular implant. None complication was seen in patients treated with IVB.
Use of IVT or IVB was safe in our experience. Patients whom required long oral steroid or immunosuppressive treatment can reduce dosis or persistent long period of oral treatment by using IVT or IVB. In general we observed better results when used IVT however in patients that we know as steroid hyperreactors we indicate bevacizumab, or patients with infectious uveitis.
This PDF is available to Subscribers Only