Intravitreal triamcinolone for uveitic cystoid macular edema: an optical coherence tomography study.

Abstract

To investigate the use of intravitreal injection of triamcinolone acetonide (TA) for the treatment of refractory uveitic cystoid macular edema (CME). Prospective, nonrandomized, self-controlled comparative trial. Six patients with chronic CME resistant to treatment with systemic steroids, orbital floor steroids, and cyclosporine A. Three patients were followed for more than 1 year, and the other three for between 3 and 9 months. Injection of 2 mg of TA into the vitreous cavity. Optical coherence tomography scanning of the fovea before and after injection and logarithmic minimal angle of resolution visual acuity. Visual acuity, retinal thickness, cystoid space height, and intraocular pressure. There was complete anatomic resolution of CME in five of the six cases within 1 week after injection. Cystoid spaces began to return between 6 weeks and 3 months after injection. Two patients with longer term follow-up responded to further orbital floor steroid injection and had no CME 1 year later. One patient had raised intraocular pressure develop, requiring a trabeculectomy. Mean improvement in visual acuity after 12 months was 0.27 (range, 0.14-0.42). Complete anatomic and, to some extent, functional recovery can be induced by intravitreal TA despite long-term refractory inflammatory CME. Optical coherence tomography aids in the management of these cases.