Fluorescein Angiography Score Research Articles

The Efficacy of a Posterior sub-Tenon’s Capsule Triamcinolone Injection in Patients with Non-infectious Intermediate Uveitis and Posterior Uveitis

Abstract To investigate the efficacy of a posterior sub-Tenon’s capsule triamcinolone injection for treating eyes with non-infectious posterior and intermediate uveitis. A total of 31 eyes from 20 patients with non-infectious posterior uveitis and 18 eyes from 10 patients with non-infectious intermediate uveitis that inadequately responded to treatment with systemic corticosteroids and second-line immunosuppressive agents were enrolled in the study. All patients received a posterior sub-Tenon’s injection of 20 mg/ml triamcinolone. The parameters we examined included the following: best corrected visual acuity, central foveal thickness, fluorescein angiography score and intraocular pressure. The mean best corrected visual acuity was significantly improved from the control visit, 0.15±0.30 logMAR (Snellen equivalent 0.7), compared to the baseline measurements, 0.60±0.30 logMAR (Snellen equivalent 0.25; P<0.05). The mean central foveal thickness (CFT) and the mean score for fluorescein angiography (FA) were significantly decreased from the baseline (CFT: 320±34 μm; FA mean score: 5.9±1.9) compared to the twelve-week control visit (CFT: 235±30 μm; FA mean score: 1.2±1.1; P<0.001). Five eyes had intraocular pressure spikes that required a topical anti-glaucomatous treatment. A posterior sub-Tenon’s injection of triamcinolone can significantly improve visual acuity and decrease macular oedema in patients with non-infectious posterior and intermediate uveitis. Complications were minimal, and there were no eyes that required surgical treatment for elevated intraocular pressure. The results suggest that the posterior sub-Tenon’s injection of triamcinolone is an important form of therapy for non-infectious posterior and intermediate uveitis.

Quantitative Analysis of Uveitis Macular Edema in Multiple Sclerosis Patients Receiving Deep Posterior Sub-Tenon Triamcinolone Acetonide Injection

Aim: We aimed to analyze the effects of adjunctive posterior sub-Tenon capsule triamcinolone acetonide injection in the treatment of intermediate uveitis macular edema in multiple sclerosis patients that could not be controlled by systemic corticosteroid medications and immunomodulators. Methods: The study included 30 eyes of 25 patients with multiple sclerosis who received a posterior sub-Tenon injection of 40 mg/mL triamcinolone acetonide. Parameters monitored for therapy efficiency were best-corrected visual acuity, intraocular pressure, central foveal thickness (CFT), and fluorescein angiography (FA) scores. Results: Mean best-corrected visual acuity was significantly improved at the control visit 0.15 ± 0.10 versus baseline 0.40 ± 0.20 logMAR (p < 0.05). Six eyes showed intraocular pressure spikes requiring topical antiglaucomatous treatment. Mean CFT and FA scores were significantly decreased versus baseline (CFT: 345 ± 50 μm; FA score: 3.4 ± 1.0) compared with the 12-week control visit (CFT: 219 ± 35 μm; FA score: 1.6 ± 1.1; p < 0.001). Conclusion: Posterior sub-Tenon injection of triamcinolone acetonide significantly improved visual acuity and decrease macular edema in patients with intermediate uveitis associated with multiple sclerosis.

Evaluation of Intraocular Inflammation with Laser Flare Photometry in Behçet Uveitis

ABSTRACTPurpose: To evaluate the association between intraocular inflammation and laser flare photometry measurements in Behçet disease.Methods: In total, 45 patients were included in the study. The retrospective chart reviews of patients were performed. The flare levels were compared with the grade of anterior chamber cells, the presence of vitreous cells, the complications of uveitis, and fluorescein angiography scores.Results: The attack group had higher flare intensity; the flare levels were higher in both groups compared with the values of healthy controls. The flare levels were related to the grade of the anterior chamber cells, the presence of vitreous cells and the fluorescein angiography scores. Patients with optic atrophy and/or maculopathy also had higher values. Higher flare values were correlated with poor vision.Conclusions: Laser flare photometry may reduce the necessity of fluorescein angiography in monitoring subclinical inflammation and may be an indicator of posterior segment activity when fluorescein angiography is not applicable.

Intravitreal Adalimumab in Active Noninfectious Uveitis: A Pilot Study

Purpose: To evaluate the short-term efficacy of intravitreal adalimumab (IVA) for the treatment of eyes with active noninfectious uveitis.Methods: Consecutive eyes with active noninfectious uveitis were injected with IVA at 0, 2, then every 4 weeks for total of 26 weeks.Results: Six out of 7 patients (12 of 13 eyes) completed 26 weeks of treatment. One patient (1 eye) failed treatment. Seven out of 12 eyes had improvement of ≥2 ETDRS lines. Three out of three eyes had resolution of anterior chamber cells. And 9 of 10 eyes with vitreous haze had zero haze at 26 weeks. Five out of 8 eyes with macular edema had complete resolution. Median fluorescein angiography score improved from 14 to 4 on last follow-up.Conclusions: IVA was effective in controlling the inflammation, decreasing the macular edema, and improving the best corrected visual acuity in the majority of eyes in this series.

Long-term progression of retinal vasculitis in Behçet patients using a fluorescein angiography scoring system.

To evaluate the long-time progression of retinal vasculitis in Behçet patients using the fluorescein angiography (FA) scoring system. Retrospective study was conducted for 71 eyes of 43 patients who met the study criteria. All patients completed at least 2years of follow-up. FA was taken during the periods of active retinal vasculitis and the quiescent phase, and analyzed using a FA scoring system. Among nine categories, the four most prevalent FA signs were evaluated: optic disc hyperfluorescence (score 0-3), macular edema (score 0-4), retinal vascular staining and/or leakage (score 0-7), and capillary leakage (score 0-10). Mean number of total active inflammations was 2.6 ± 1.5 times during mean 55.0 ± 20.0months. Mean scores at the first active inflammation were 1.8 ± 1.0 for optic disc hyperfluorescence, 2.4 ± 1.0 for macular edema, 5.3 ± 2.1 for retinal vascular staining and/or leakage, and 5.8 ± 3.2 for capillary leakage. Mean total FA score was 17.4 ± 6.8. Mean scores at the first quiescent phase were 0.6 ± 0.4 for optic disc hyperfluorescence, 1.1 ± 1.2 for macular edema, 3.8 ± 1.9 for retinal vascular staining and/or leakage, and 3.5 ± 3.5 for capillary leakage. Mean total FA score was 9.1 ± 5.0. Mean scores for each active inflammation and quiescent phase were not significantly changed, and mean FA scores were significantly reduced in quiescent phase (P = 0.003 for optic disc hyperfluorescence, P = 0.005 for macular leakage, P = 0.010 for retinal vascular staining and/or leakage, P = 0.008 for capillary leakage, and P = 0.018 for total FA score; paired t-test). Retinal vasculitis of Behçet patients did not significantly progress during long-term follow-up.