Treatment of Cystoid Macular Edema in Retinitis Pigmentosa With Intravitreal Triamcinolone Acetonide

Abstract

Abstract: : Purpose: to evaluate the efficacy of intravitreal triamcinolone acetonide treatment in patients affected by retinitis pigmentosa (RP) complicated by cystoid macular edema (CME). Methods: a multicentric, prospective study was conducted in two centers. Two groups of 10 patients affected by RP and CME were randomizely selected respectively at University of Bologna and University of Messina, Italy. In each group 1 eye was treated and the other eye served as control. CME was evaluated by fundus oftalmoscopy, fluorescein angiography and optical choerence tomography (OCT). All of them received an intravitreal injection of 0.1 ml (40 mg/ml) of triamcinolone acetonide. Mean follow–up was 12.4±3.1 months. Evaluation paramenters were: best corrected visual acuity (BCVA) (ETDRS), biomicroscopy, IOP and OCT. Results: we compared the results using Student T–test and Wilcoxon statistical analysis. BCVA remained stable and IOP increased significantly within the first week, reaching a maximum value at 1 to 5 months after the injection and returning to baseline values at 6 to 14 months postinjection. OCT before treatment showed a macular thickness of 463.1±85µ in group 1 and 539.7±63µ in group 2. After 5 months macular thickness in group A was 224.7± 56.8, in group B was 218.4±48.3. After 12 months OCT showed a macular thickness of 433.7± 62.2 in group A and in group B 498.6±37.4µ. Conclusions: intravitreal triamcinolone actonide may be useful for selected cases of CME in patients affeted by RP but the efficacy seems to be limited in time. It could help to prevent complications as macular holes, already related to vitreal pathogenesis and cystic foveal degenration in retinitis pigmentosa.

Keywords: retinal degenerations: hereditary • retina • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled