Safety and Efficacy of Intravitreal Triamcinolone Acetonide in Patients With Non-Infectious Uveitis

Abstract

Abstract: : Purpose: To evaluate the safety and efficacy of intravitreal triamcinolone acetonide for treatment of patients with non-infectious uveitis. Methods: Four milligrams (0.1 ml) of triamcinolone acetonide was injected under topical anesthesia into the vitreous cavity of patients with active uveitis and/or cystoid macular edema associated with uveitis. Visual acuity, activity of uveitis, intraocular pressure and presence of cystoid macular edema were recorded prior to the administration of injection and during the follow-up period. Results: Twenty-four patients (28 eyes) were studied. The mean age of patients was 47 years (range 21-71). Male to female ratio was 1:5. Eleven patients were diagnosed with intermediate uveitis, seven patients with panuveitis and six patients with posterior uveitis. The presence of cystoid macular edema was documented in 24 eyes (86%) and active uveitis in 11 eyes (39%) before the treatment. The mean visual acuity and mean intraocular pressure were 0.22 (range 0.01-0.67) and 13.3 mmHg (range 0-22), respectively, prior to the administration of injection. The mean follow-up time was 21 weeks (range 2-44). At the last follow-up visit active uveitis was documented in two eyes (7%) and cystoid macular edema in eight eyes (29%). The visual acuity improved by two or more lines in 10 eyes (30%) and stayed unchanged in the remaining 18 eyes (70%). The mean intraocular pressure at the last follow-up visit was 15.9 mmHg (range 0-33) and did not reach statistically significant difference (p>0.05) compared to values obtained before the treatment. Elevated intraocular pressure (more than 21 mmHg) was recorded in 14 eyes (50%) during the follow-up period and in six eyes (21%) at the last visit. All cases of ocular hypertension were managed with glaucoma medication. No other major side effects were recorded during the follow-up period. Conclusions: Intravitreal triamcinolone acetonide is safe and effective in controlling the activity of non-infectious uveitis and cystoid macular edema. Elevation of intraocular pressure is the most common side effect; it is typically transient and requires conservative management.

Keywords: uveitis-clinical/animal model • vitreous • autoimmune disease