Efficacy and complications of intravitreal injection of triamcinolone acetonide for refractory cystoid macular edema associated with intraocular inflammation.

OBJECTIVE

To assess the effects and complications of intravitreal injection of triamcinolone acetonide (IVTA) for posterior sub-Tenon injection of triamcinolone acetonide (PSTA)-resistant cystoid macular edema (CME) with intraocular inflammation.

METHODS

Medical records of eight eyes of six patients with PSTA-resistant CME were retrospectively examined. Each eye received a 4-mg IVTA, and an additional injection was performed when CME recurred. Visual acuity as logarithm of the minimum angle of resolution (logMAR), intraocular pressure (IOP), and central macular thickness (CMT) were assessed before and after each treatment.

RESULTS

CME improved in six eyes (75%) with mean visual acuity recovering from 0.56+/-0.29 to 0.41+/-0.195 (logMAR, P=0.13) and mean CMT decreasing from 470 microm (range, 275-660 microm) to 297 microm (range, 150-697 microm) (P=0.04) 2 months after the initial IVTA. CME recurred an average of 9 months (range, 5-11 months) after IVTA. A higher dose (16-mg) IVTA was effective for two eyes refractory to repeated 4-mg IVTA. IOP was elevated in two eyes (25%), of which one required filtration surgery (12.5%). In phakic eyes, cataracts progressed and necessitated surgery.

CONCLUSIONS

IVTA is effective for PSTA-resistant CME with intraocular inflammation, and its efficacy might be dose dependent.