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L. Arellanes–Garcia, P. Navarro, M. Preciado; Intravitreal Triamcinolone for Uveitic Chronic Cystoid Macular Edema. Optical Coherence Tomography, Fundus Fluorescein Angiography and Multifocal Electroretinogram Study . Invest. Ophthalmol. Vis. Sci. 2005;46(13):487.
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Purpose: To evaluate the efficacy and safety of intravitreal triamcinolone in the treatment of chronic Cystoid Macular Edema (CME) secondary to uveitis refractory to treatment, using fundus fluorescein angiography (FFA), Optical coherence tomography (OCT) and multifocal electroretinogram (mfERG) to evaluate response. Methods: Ten patients with chronic CME resistant to conventional treatment were included. Ocular diagnosis were: mixed connective tissue disease (1), intermediate uveitis (1), panuveitis (2), idiophatic vasculitis (2), chronic iridociclitis(3), chronic endophthalmitis (1). Baseline examination was performed including VA, FFA, OCT and mfERG. An intravitreal injection of triamcinolone (4mg/0.1ml) was given. Patients were evaluated at 1, 3, 6, 12 and 18 months. Results: Median VA prior to injection was 20/50, best VA after injection was 20/30, and final VA was 20/40. Inicial FFA showed severe CME in 10 eyes, moderate in one. After treatment FFA showed mild CME in 10 eyes and moderate in one. OCT initial central macular thickness was 501.3 um, final 228.1 um. In all cases an increase of the B wave amplitude was shown in the mfERG. One patient developed posterior subcapsular cataract. Transitory ocular hypertension developed in 2 patients. Conclusions: Intravitreal triamcinolone acetonide is effective as a short–term treatment for chronic CME in uveitis patients. Chronic CME did not disappear in any patient either by FFA or OCT. However all patients demostrated angiographic improvement and decreased macular thickness was demonstrated by OCT. Functional improvement was shown in VA and mfERG.
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