Abstract
Purpose :
The ideal steroid delivery mechanism to treat Cystoid Macular Oedema (CMO) in Inflammatory Eye Disease (IED) is currently uncertain. Intravitreal steroid injections risk introducing infection, elevating Intraocular Pressure (IOP) and require a day-case admission. Intramuscular-methylprednisolone injection (IMMP) avoids the complications of intravitreal injection, is well tolerated, and can be performed easily in an outpatient setting. This poster is a retrospective, clinical analysis of patients who have undergone IMMP for CMO and their clinical outcomes.
Methods :
Retrospective case note analysis of consecutive patients receiving IMMP for CMO due to IED at a large, tertiary-referral eye hospital between 7th July 2009 and 8th Jan 2023. Data was obtained from entries on the hospital Clinical Data Archive (CDA) and letter system (Winscribe). Resolution of CMO was quantified through assessment of Central Macular Thickness (CMT) as measured by Optical Coherence Tomography (OCT). Pre- and post-treatment Snellen visual acuity and IOP were recorded. Outcome data was collected for the first 3 appointments following each IMMP treatment. Statistical analysis was done using R statistical software.
Results :
54 patients (67 eyes) were included in analysis; 5 (9.3%) received 2 injections and 1 (1.9%) received 3 injections of IMMP. CMO was due to anterior uveitis in 21/54 (38.9%), panuveitis in 20/54 (37.0%), and posterior uveitis in 1/54 (1.9%). 7 patients had bilateral CMO at time of treatment. At first follow up, 41/67 (61.2%) eyes demonstrated improvement in CMO on OCT with 8/67 (11.9%) having complete resolution; 44/67 (65.7%) demonstrated improvement by second follow up and 39/67 (58.2%) eyes demonstrated improvement at third follow up. 43/67 (64.2%) eyes had a recurrence of CMO with average time to failure being 1,764 days (329-2,245 95% CI). 62 eyes had recorded visual acuity pre- and post-IMMP treatment, 55/62 (88.8%) eyes showed stable or improved visual acuity at first follow up, with 24/62 (38.7%) having improvement of 2 lines or more. 23 patients had IOP values recorded, no significant difference in IOP was found pre- and post-IMMP treatment (P>0.05, Mann-Witney U test). No adverse events were reported by any patient.
Conclusions :
Intramuscular Methylprednisolone Injection shows promise in the treatment of Cystoid Macula Oedema in Inflammatory Eye Disease.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.