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C.L. Tucker, R. Morris, C.D. Witherspoon; Resolution of Vitreomacular Traction and Cystoid Macular Edema by Intravitreal Injection of Triamcinolone . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5544.
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We present a case of cystoid macular edema (CME) resultingfrom vitreomacular traction syndrome (VMTS) which was correctedby detachment of the posterior vitreous after intravitreal triamcinoloneinjection. The CME was clinically inapparent one month post–injectionand Optical Coherence Tomography (OCT) confirmed complete resolutionof the VMTS with a detached posterior hyaloid face.
This patient is a 70 year–old female who complainedof a central scotoma in her right eye, present for six months.Uncomplicated cataract extraction had been performed four yearsearlier. YAG–laser posterior capsulotomy was recentlyperformed, but did not improve her symptoms. Approximately fourmonths later, she presented to our service and was found tohave cystoid edema in the central fovea. OCT confirmed a singlefoveal "cyst," but also revealed VMTS to its edges. The patientwas offered intravitreal injection of triamcinolone.
Triamcinolone 0.1 ml (40 mg/1 ml) was injected throughthe pars plana into the inferior vitreous cavity. One monthlater, the patient reported near total resolution of her symptoms.The CME appeared completely resolved by clinical examination.OCT revealed minimal residual edema and complete resolutionof the VMTS with the posterior hyaloid face elevated above theretinal surface.
Intravitreal injection of triamcinolone has beenshown to be effective at improving diabetic and post–operativecystoid macular edema refractory to other treatments. In casesof cystoid macular edema with associated vitreomacular traction,the injection itself may be an effective method to induce posteriorvitreous separation and relief of the traction.
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