Abstract
Purpose :
Suprachoroidal triamcinolone acetonide (CLS-TA) is the first medication utilizing the suprachoroidal space approved in the United States for treatment of retinal disease. It is unknown if presence of a scleral buckle, which may compress the suprachoroidal space, may limit delivery of the medication and limit effectiveness. The purpose of this study is to evaluate outcomes of suprachoroidal CLS-TA in eyes with a scleral buckle and uveitic macular edema (UME).
Methods :
A retrospective chart review of eyes with a scleral buckle who underwent suprachoroidal CLS-TA injection for UME was conducted. The primary outcome was met if one of the following criteria was met at 6 weeks after the injection: 1) 20% or more reduction in central subfield thickness (CST) on optical coherence tomography (OCT), or 2) resolution of intraretinal and/or subretinal fluid on OCT. Secondary outcomes included change in CST, change in LogMAR visual acuity (VA), and change in intraocular pressure (IOP). Paired t-tests were used to compare values before and after the procedure, and p values less than 0.05 were considered significant.
Results :
6 eyes with intermediate, posterior, or panuveitis from 6 patients were included. 5 out of the 6 (83%) patients were male. The median age was 68 years (range 30 - 77). 4 of the eyes were right eyes (66.7%). At 6 week follow-up, mean CST improved from 372.4 microns (standard deviation (SD) 70.1) to 327.7 microns (SD 29.6) (mean difference 44.7, p = 0.085). Mean LogMAR visual acuity decreased from 0.3 (SD 0.2) to 0.4 (SD 0.3) (mean difference 0.1, p = 0.072). Mean intraocular pressure did not change significantly (13.8 mmHg (SD 3.0) vs 13.5 mmHg (SD 3.8), mean difference 0.3, p = 0.646). The primary outcome was met in 3 of 6 eyes (50%). Egress of CLS-TA, indicating incomplete injection of the medication into the suprachoroidal space, was noted in 2 eyes (33.3%); both of these eyes did not meet the primary outcome. In the 4 eyes in which no egress was noted, the primary outcome was met in 3 of these eyes (75%).
Conclusions :
Outcomes of suprachoroidal triamcinolone acetonide (CLS-TA) injection in eyes with scleral buckles for UME are modest. While outcomes were favorable in eyes in which no significant egress of the medication was noted during the injection, in eyes in which there is egress of the medication during the injection, an alternative treatment modality may need to be considered.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.