Abstract:
To evaluate the safety and efficacy of intravitreal triamcinolone acetonide (IVTA) in the treatment of various retinal disorders.
A retrospective chart review. Sixty–five eyes of 64 patients were given a 4mg/0.1cc intravitreal injection of triamcinolone acetonide by a single surgeon during a one year period. Patients had a minimum of 100 days of follow–up within 5/13/2003 to 5/10/2004. Patients were reexamined at days 3, 10, 40, 70 and 100 postinjection.
Eight conditions were examined: macular edema secondary to BRVO that was not amenable to grid laser after 3 months (8), macular edema secondary to ischemic central retinal vein occlusion (CRVO) (4), macular edema secondary to nonischemic–CRVO (5), macular edema secondary to hemi–CRVO (4), cystoid macular edema (CME) recalcitrant to posterior subtenons triamcinolone injection (12), diabetic macular edema (DME) involving the foveal center (21), subfoveal choroidal neovascular membrane (CNVM) in conjunction with photo dynamic therapy (PDT) (4), and eyes with two or more of the above conditions (7).
Forty percent of eyes with preexisting glaucoma developed steroid response glaucoma (SRG) versus 16% without preexisting glaucoma. Patients who developed SRG were controlled with topical medications. No patients developed endophthalmitits.
This preliminary data shows that most groups benefited from IVTA, but the effect tended to fade after 3 months in some patients. The BRVO and Hemi–CRVO groups benefited most, while the eyes with > 2 of the conditions benefited least. Some patients required a second injection after 3 months and are currently being followed for future study. Glaucoma was a preexisting risk factor for developing steroid response glaucoma. Intravitreal triamcinolone acetonide injection is a safe and effective treatment.
Keywords: retina • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled • pharmacology