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

Purpose: To investigate the use of intravitreal injection of triamcinolone acetonide (TA) for the treatment of refractory uveitic cystoid macular edema (CME). Design: Prospective, nonrandomized, self-controlled comparative trial. Participants: 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, Intervention: Injection of 2 mg of TA into the vitreous cavity, Testing: Optical coherence tomography scanning of the fovea before and after injection and logarithmic minimal angle of resolution visual acuity, Main Outcome Measures: Visual acuity, retinal thickness, cystoid space height, and intraocular pressure. Results: 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). Conclusions: 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. (C) 2001 by the American Academy of Ophthalmology.