Intravitreal reinjection of triamcinolone for exudative age-related macular degeneration

Objective: To evaluate the outcome of repeated intravitreal injections of triamcinolone acetonide for the treatment of exudative age-related macular degeneration. Methods: This prospective, comparative nonrandomized clinical interventional. study included 13 patients with progressive exudative age-related macular degeneration with occult, or predominantly occult, subfoveal neovascularization. All patients had shown an increase or stabilization of visual acuity after a first intravitreal injection of 25 mg of triamcinolone acetonide. They received a second intravitreal injection of 25 mg of triamcinolone acetonide 3.1 to 18 months after the first injection. Mean +/- SD follow-up time after the second injection was 5.2 +/- 3.6 months (median, 5.3 months). A control group included 24 patients with exudative age-related macular degeneration who did not receive treatment for their maculopathy. The main outcome measures were visual acuity and intraocular pressure. Results: In the study group, mean +/- SD visual acuity increased significantly (P = .005 and P = .003, respectively) from 0.17 +/- 0.11 to 0.32 +/- 0.26 and from 0.15 +/- 0.14 to 0.23 +/- 0.19, respectively, after the first and second injections. An increase in visual acuity was found for 10 patients (77%) after the first and second injections. In the control group, visual acuity did not vary significantly during follow-up (P = .81). The difference in change in visual acuity between the study group and control group was significant (P = .01 [Snellen lines] and P = .05 [logMAR units]). The peak in visual acuity and, in a chronologically parallel manner, the peak in intraocular pressure elevation occurred 2 to 5 months after each injection. Conclusions: Repeated intravitreal injection of 25 mg of triamcinolone acetonide may lead to an increase in visual acuity in patients with exudative age-related macular degeneration, with the peak in visual acuity and intraocular pressure elevation occurring about 2 to 5 months after each injection.