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E. Azan, L. Haddad, E. Delaire, D. Monnet, C. Elie, A.P. Brezin; OCT Imaging of the Effect of Subtenon or Intravitreal Triamcinolone Acetonide Injections in Uveitic Macular Edema . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1522.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze the effects of subtenon or intravitreal triamcinolone acetonide (TA) injections on uveitic macular edema, by Optical Coherence Tomography (OCT) imaging.
Retrospective study of 60 consecutive patients seen in a referral center for uveitis, which were treated by TA injections (27 intravitreal and 42 subtenon, 9 bilateral). When repeat injections were performed, only the effect of the first injection was considered. The causes of uveitis were birdshot chorioretinopathy (n=17), sarcoidosis (n=9), HLA B27 or inflammatory bowel disease uveitis (n=7), tuberculosis (n=5), Behçet’s disease (n=3), idiopathic posterior uveitis or panuveitis (n=19). Triamcinolone acetonide dosages were 4mg in 0.1 ml for intravitreal and 40 mg in 1ml for subtenon injections. Visual acuity and the results of OCT imaging (macular thickness in central 1mm) were studied before and 60 +/– 10 days after injection. Complications of therapy were recorded.
Pre–treatment, the mean macular thickness was greater in patients treated by intravitreal injections (471.7+/– 12.9 µm ) than in patients treated by subtenon injections (359.7 +/– 11.1 µm) (p=0.0021). Pre–treatment mean decimal visual acuity was lower in patients treated by intravitreal injections 0.2 [range 0.05–0.8] (p= 0.028) than in patients treated by subtenon injections 0.4 [range 0.05–1.0]. The mean decrease in macular thickness was greater in patients treated by intravitreal injections (–180.8 +/– 12.9 µm) than in patients treated by subtenon injections (–100.1 +/– 10.8 µm ) (p=0.033). The mean improvement of visual acuity was 1 line in the intravitreal injection group and 1.5 lines in the sub–Tenon group (p=0.033 ) . Intraocular pressure >21 mmHg was observed in 7 (25.9%) cases after intravitreal injections and in 3 (7.1%) cases after subtenon injections. All cases of ocular hypertension were transient and responded to medical therapy.
A greater decrease in macular thickness and a better improvement of visual acuity were observed after intravitreal injections than after subtenon injections.
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