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T.M. Johnson, B.M. Glaser; Anterior Subtenon Triamcinolone Injection for Management of Macular Edema Secondary to Retinal Vascular Disease . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4243.
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Increasing data suggests triamcinolone may be a useful adjuvant in the treatment of macular edema associated with retinal vascular disease. Intraocular and juxtascleral injections have been proposed as alternative delivery routes. Studies of juxtascleral injection to date have focused on a posterior approach. This study examines the role of anterior subtenon injection for the treatment of macular edema secondary to retinal vascular disease.
A retrospective review of patients receiving anterior subtenon injections of 40 mg of triamcinolone was conducted. Patients included had macular edema non responsive to previous focal laser treatment secondary to diabetic retinopathy, branch or central retinal vein occlusion. Outcome measures included ETDRS visual acuity, intraocular pressure, retinal thickness and volume on OCT.
8 patients with a minimum of 3 months follow up were reviewed. Average baseline visual acuity was 20/80. Average central retinal thickness was 460 microns. Patients received a single 40 mg anterior subtenon steroid injection. At most recent follow up average visual acuity was 20/63+2. Average central retinal thickness was significantly reduced at 292 microns (p<0.005). No significant rise in intraocular pressure or progression of cataract was noted.
The role of corticosteroids as adjuvant therapy for macular edema continues to be studied. Intraocular injections may be associated with complications including endophthalmitis. This study suggests that alternative delivery routes, including anterior subtenon, may result in reduction in edema without significant risk of complication and may be an acceptable alternative to intraocular injection. The long term efficacy of treatment needs to be determined.
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