Abstract
Purpose :
Suprachoroidal triamcinolone acetonide (CLS-TA) is a safe and effective treatment for uveitic macular edema. Vascular leakage on fundus fluorescein angiography (FA), which is often present in intermediate, posterior, and panuveitis, is commonly used to assess disease activity in clinical practice. The impact of treatment with suprachoroidal CLS-TA on vascular leakage on FA, an important outcome measure in the treatment of uveitis, is currently unknown.
Methods :
We conducted a retrospective chart review of patients with noninfectious uveitis who underwent suprachoroidal CLS-TA injection and had FA performed 6 weeks prior to the injection and 6 weeks after the injection. A previously published 40-point grading system for FA images was utilized to grade the FA images, and masked grading was performed independently by two graders. Scores between the two graders were averaged. Additionally, central subfield thickness (CST) on optical coherence tomography (OCT), best corrected visual acuity, and intraocular pressure (IOP) at the time of injection and at 6 week follow up were evaluated. Paired t-tests were performed, and p values less than 0.05 were considered significant.
Results :
A total of 8 eyes from 8 patients were included. 4 out of the 8 (50%) patients were female. The median age was 73.5 years (range 25-82). All eyes had intermediate, posterior, or panuveitis.
The mean FA score before suprachoroidal CLS-TA injection was 12.3 (SD 4.7), and the mean score at 6-week follow-up was 11.0 (SD 2.1), with a mean difference of 1.3 (p-value = 0.852). Mean initial central subfield thickness on OCT was 408.4 (SD 44.5), and mean follow up CST was 337.7 (SD 30.5), with a mean difference of 70.7 (SD 25.3) (p-value = 0.0135). Mean initial visual acuity (LogMar) was 0.71 (SD 0.24) and mean visual acuity at 6 week follow up was 0.51 (SD 0.11), with a mean difference of 0.20 (p-value = 0.877). Mean initial IOP was 14.4 (SD 2.6), and mean IOP at 6 week follow up was 13.1 (SD 3.3) with a mean difference of 1.3 (p-value= 0.614).
Conclusions :
While suprachoroidal CLS-TA is effective for the treatment of uveitic macular edema, it has minimal impact on vascular leakage on FA, a key outcome measure in the treatment of uveitis. Eyes with significant vascular leakage on FA may require supplemental or alternative treatment with systemic or local therapies to achieve disease control.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.