Abstract
Purpose: :
To evaluate the efficacy of intravitreal triamcinolone acetonide for the management of postvitrectomy diabetic vitreous hemorrhage.
Methods: :
Design : Prospective, noncomparative, interventional case series Participants : 17 eyes of 18 consecutive patients with postvitrectomy diabetic vitreous hemorrhage. Intervention : All patients were administered 4mg(0.1 cc) of triamcinolone acetonide ophthalmic suspention. Main Outcome measures : Changes in visual acuity, clearance of vitreous hemorrhage and the development of complication such as increased intraocular pressure was monitored.
Results: :
Visual acuity at the time of the IVT injection was ranged from LP to 20/200. 16 of 18 eyes(88%) experienced clearing of vitreous hemorrhage with in 1 to 7 weeks (mean; 2.2 weeks). Of 16 eyes, 15 eyes had visual improvement with a mean visual acuity of 20/160(range CF 20/63). Mean follow–up after IVT injection was 12weeks. Of 16 eyes, 5 eyes developed recurrent vitreous hemorrhage after clearing of vitreous hemorrhage. The vitreous hemorrhage was not cleared in 2 eyes, in which surgical procedure was needed.
Conclusions: :
Intravitreal triamcinolone acetonide injection may be an alternative treatment to air–fulid exchange or repeat vitrectomy. This is less invasive procedure and provides more prompt visual recovery
avoiding face–down position. We believe that the rapid clearing of
vitreous hemorrhage results from as follows: (1) triamcinolone delivered
in vitreous cavity can give rise to mechanical sediment entangled with
remained blood (2) direct vascular stabilizing effect may be induced (3)
antiangiogenic effect may play a role. For further investigation, long term
follow up is needed.
Keywords: diabetic retinopathy • injection • vitreoretinal surgery