Trans–Tenon's Retrobulbar Triamcinolone Infusion for Small Choroidal Neovascularization: A Pilot Study

Abstract

Abstract: : Purpose: Corticosteroids are currently being evaluated for the treatment of choroidal neovascularization. The purpose of this pilot study was to assess the efficacy of trans–Tenon's retrobulbar infusion of triamcinolone acetonide for the treatment of small choroidal neovascular membranes. Methods: Twenty–two eyes with subfoveal choroidal neovascularization (CNV) of less than or equal to 1 disc diameter in size were treated with 20 mg triamcinolone acetonide administered as a trans–Tenon's retrobulbar infusion. The diagnoses were age–related macular degeneration in 14 eyes, idiopathic CNV in 4 eyes, polypoidal choroidal vasculopathy in 3 eyes, and punctate inner choroidopathy in 1 eye. All eyes were followed for at least 4 months, with a mean follow–up of 7.4 months. Results: Lesions in 14 eyes (64%) were observed to undergo fibrosis, with decreased leakage on fluorescein angiography at 3 months in 12 of 22 eyes (55%). Visual acuity stabilized or improved by 0.2 logMAR or more in 17 eyes (77%). Conclusions: Trans–Tenon's retrobulbar triamcinolone infusion was associated with lesion fibrosis in 64% and decreased fluorescein angiographic leakage in 55% of eyes with small choroidal neovascular membrane, suggesting that this treatment may warrant further controlled studies.

Keywords: choroid: neovascularization • age–related macular degeneration • corticosteroids