Abstract
Purpose :
Suprachoroidal triamcinolone acetonide (SCS-TA) was approved to treat uveitic macular edema on 10/25/2021, but there has been minimal literature published on its real-world efficacy. This is the first retrospective study after SCS-TA approval that assesses its efficacy in patients with non-infectious uveitic cystoid macular edema (CME).
Methods :
This is a retrospective single-site, multi-provider study which includes 25 eyes of 20 patients. All eyes that received SCS-TA for uveitic or post-surgical CME with a central subfoveal thickness (CST) ≥ 300 µm since 1/1/2022 were included. Patients without follow-up spectral-domain optical coherence tomography (OCT) imaging were excluded. Primary outcome measures were duration of efficacy as well as pre- and post-injection best corrected visual acuity (BCVA), CST, and intraocular pressure (IOP). Amount of CME was calculated as the difference between CST and baseline CST. Data was collected until there was change in medical management.
Results :
The 25 eyes had a pre-injection mean BCVA of 0.57 ± 0.48 logMAR, IOP of 13.4 ± 2.7 mmHg, and CST of 511.1 ± 141.7 µm. The average CST of the 18 eyes that had a baseline SD-OCT without CME was 284.9 µm ± 22.7. The 7 eyes with no established CST baseline were assigned a baseline CST of 300 µm. The average amount of CME pre-injection was 222.0 ± 138.6 µm. First follow-up occurred 36.0 ± 26.7 days after injection. Eight eyes did not respond to treatment, 2 eyes had reduced CST until at least the first follow-up (46.5 ± 3.5 days), and 15 eyes had no recurrence of CME to date (89.0 ± 82.6 days). Average duration of uncontrolled CME prior to SCS-TA was 149 days (range 0-471) for non-responders, 151 days (range 146-155) for partial responders, and 70 days (range 0-245) for complete responders. In the 17 patients who responded to therapy, the average decrease in CME was 74.9% (range 32-100%), average BCVA improved to 0.47 ± 0.22 logMAR, and average IOP increased by 2.9 ± 3.9 mmHg at first follow-up. One patient had sustained IOP elevations that required therapy. None of the 3 patients with history of IOP steroid response experienced significant IOP elevation.
Conclusions :
Preliminary data show that SCS-TA may help treat uveitic CME, particularly in less chronic cases. IOP elevation with SCS-TA was minimal, even in patients with a history of steroid response.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.