Abstract
Abstract: :
Purpose:To evaluate the safety and efficacy of Sub–Tenon’s injection of Triamcinolone Acetonide in Cystoid Macular Edema complicating uveitis using a modified technique. Methods:Fourteen eyes (5 right, 9 left) of eleven patients with posterior uveitis underwent Sub–Tenon’s steroid injection using a modified technique. The modification included the usage of a 28 G 0.5 inches long brown needle. All eyes had Optical Coherence Tomography (OCT) evaluation of macular edema before and after the injection using OCT–3 from CARL ZEISS, in addition to clinical assessment. Results:The duration of uveitis ranged from 12 to 48 months (mean of 30 months, median of 34 months). The final diagnosis was intermediate uveitis in 12 eyes and anterior uveitis in 2 eyes. The pre–treatment log MAR visual acuity ranged from 0.2 to 1.2 (mean of 0.7). Clinical cystoid macular edema was found in 5 eyes, while 6 eyes were suspected to have edema. Epiretinal membrane was found in 2 eyes. Pre–treatment cataract was seen in 3 eyes. OCT detected macular edema in all eyes. OCT macular thickness was measured to assess the efficacy of the injection. All patients were on systemic steroids. Additional steroid sparing immunosupression was given in four patients while three patients could not tolerate it. The final log MAR visual acuity ranged from 0 to 1.2 (mean of 0.36). Intraocular pressure rise was seen in 3 eyes of 2 patients that were medically controlled. Conclusions:No sight threatening complications were encountered due to the treatment in any of cases. The Sub–Tenon’s injection using the modified technique was found to be safe and effective. Raised intraocular pressure was encountered that was satisfactorily controlled with medication.
Keywords: inflammation • uveitis–clinical/animal model • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)