Safety and efficacy of intravitreal triamcinolone acetonide for uveitis macular edema

Abstract

A retrospective study was performed to evaluate the use of intravitreal triamcinolone acetonide (TA) for treating chronic cystoid macular edema (CME) secondary to non-infectious uveitis. Twenty eyes of 16 patients (three men, 13 women) with chronic CME as a consequence of controlled intermediate uveitis (three patients), posterior uveitis (seven patients), or panuveitis (six patients) who received at least one injection of TA were included in the analysis. The mean patient age was 45.3 years (range, 21 to 73 years). The mean duration of CME was 18.1 ± 15.9 months. The mean duration of follow-up was 34 weeks (range, 19 to 56 weeks). At the last follow-up, visual acuity (VA) showed improvement in 11 eyes (55%), was unchanged in six eyes (30%), and deteriorated in three eyes (15%). Mean VA showed statistically significant improvement in 11 nonvitrecomized eyes (mean baseline VA: 1.14 ± 0.58; final mean VA: 0.96 ± 0.66, P = .02), but remain essentially unchanged in nine prior victrectomized eyes. At the most recent examination, CME had resolved in 10 eyes (50%) and had persisted or relapsed in 10 eyes (50%). Elevation of intraocular pressure was transient in all cases and responded well to topical medications, except one eye that required placement of an Ahmed valve implant. Preexisting cataracts progressed in three (20%) of the 15 phakic eyes. One patient developed a retinal detachment. The authors conclude that intravitreal TA may play a role in the treatment of uveitis-related CME.—Michael D. Wagoner