 |
|
Intravitreal Triamcinolone for the Treatment of Macular Edema Associated With Central Retinal Vein Occlusion
Michael S. Ip, MD;
Justin L. Gottlieb, MD;
Alon Kahana, MD, PhD;
Ingrid U. Scott, MD, MPH;
Michael M. Altaweel, MD;
Barbara A. Blodi, MD;
Ronald E. Gangnon, PhD;
Carmen A. Puliafito, MD, MBA
Arch Ophthalmol. 2004;122:1131-1136.
Objective To investigate the safety and efficacy of intravitreal triamcinolone acetonide as treatment for macular edema associated with central retinal vein occlusion (CRVO).
Methods We reviewed the medical records of 13 consecutive patients (13 eyes) with macular edema associated with CRVO who were treated with an injection of intravitreal triamcinolone acetonide (4 mg) at the University of Wisconsin and the Bascom Palmer Eye Institute. Each intravitreal injection was delivered through the pars plana using a 27- or 30-gauge needle.
Main Outcome Measures Change in Snellen visual acuity, clinical appearance of macular edema, measurement of foveal thickening with optical coherence tomography (OCT), and frequency of complications.
Results The median age of the 13 patients was 67 years (interquartile range, 57-77 years), and the median duration of symptoms before injection was 8 months (interquartile range, 4-9 months). Mean baseline visual acuity was 20/500 in the affected eye. Mean visual acuity at the 6-month follow-up examination was 20/180 in the affected eye. All 13 patients completed the 6-month examination. Eyes with nonischemic CRVO (n = 5) demonstrated a significant improvement in visual acuity, whereas eyes with ischemic CRVO (n = 8) demonstrated a nonsignificant visual acuity improvement. No patient had a decrease in visual acuity. Mean baseline foveal thickness as measured by OCT was 590 µm (retinal thickening = 416 µm). Mean foveal thickness as measured by OCT at the 1-month follow-up examination in 12 patients was 212 µm (retinal thickening = 38 µm). At the 3-month follow-up examination, mean foveal thickness as measured by OCT for 13 patients was 193 µm (retinal thickening = 19 µm). Between the 3- and 6-month follow-up examinations, 4 patients developed a recurrence of macular edema. Three of the 4 patients were retreated with a second injection of triamcinolone. Two of these 3 patients experienced an improvement in visual acuity following retreatment. At the 6-month follow-up examination, mean foveal thickness as measured by OCT for 13 patients was 281 µm (retinal thickening = 107 µm). No adverse effects such as retinal detachment or endophthalmitis occurred. One patient experienced an increase in intraocular pressure that was controlled with 2 aqueous suppressants.
Conclusions Intravitreal injection of triamcinolone appears to be a possibly effective treatment in some patients with macular edema associated with CRVO. Patients with nonischemic CRVO may respond more favorably than patients with ischemic CRVO, and retreatment may be necessary in some patients. In this case series, severe complications were not noted.
From the Department of Ophthalmology and Visual Science (Drs Ip, Gottlieb, Kahana, Altaweel, and Blodi) and Department of Biostatistics and Medical Informatics (Dr Gangnon), University of Wisconsin, Madison; and the Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine, Miami, Fla (Drs Scott and Puliafito). The authors have no relevant financial interest in this article.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Trans-Tenon's retrobulbar triamcinolone acetonide injection for macular oedema related to branch retinal vein occlusion
Kawaji et al.
Br. J. Ophthalmol. 2008;92:81-83.
ABSTRACT
| FULL TEXT
Cytotoxicity of Triamcinolone Acetonide on Human Retinal Pigment Epithelial Cells
Chang et al.
IOVS 2007;48:2792-2798.
ABSTRACT
| FULL TEXT
Randomized Controlled Study of an Intravitreous Dexamethasone Drug Delivery System in Patients With Persistent Macular Edema
Kuppermann et al.
Arch Ophthalmol 2007;125:309-317.
ABSTRACT
| FULL TEXT
Long-term Retinal Toxicity of Intravitreal Commercially Available Preserved Triamcinolone Acetonide (Kenalog) in Rabbit Eyes
Albini et al.
IOVS 2007;48:390-395.
ABSTRACT
| FULL TEXT
Triamcinolone Acetonide Inhibits IL-6- and VEGF-Induced Angiogenesis Downstream of the IL-6 and VEGF Receptors
Ebrahem et al.
IOVS 2006;47:4935-4941.
ABSTRACT
| FULL TEXT
Triamcinolone Reduces Neovascularization, Capillary Density and IGF-1 Receptor Phosphorylation in a Model of Oxygen-Induced Retinopathy
Hartnett et al.
IOVS 2006;47:4975-4982.
ABSTRACT
| FULL TEXT
Effects of Intravitreous Injection of Preserved and Nonpreserved Triamcinolone in Rabbit Retina--Reply
Dierks et al.
Arch Ophthalmol 2006;124:1666-1668.
FULL TEXT
The problem of pressure elevation associated with intravitreal triamcinolone.
Conway
Br. J. Ophthalmol. 2006;90:934-935.
FULL TEXT
Radial Optic Neurotomy for Management of Hemicentral Retinal Vein Occlusion.
Garcia-Arumi et al.
Arch Ophthalmol 2006;124:690-695.
ABSTRACT
| FULL TEXT
The management of retinal vein occlusion: is interventional ophthalmology the way forward?
Shahid et al.
Br. J. Ophthalmol. 2006;90:627-639.
ABSTRACT
| FULL TEXT
Sequenced combined intravitreal triamcinolone and indocyanine green angiography-guided photodynamic therapy for retinal angiomatous proliferation.
Freund et al.
Arch Ophthalmol 2006;124:487-492.
ABSTRACT
| FULL TEXT
Should corticosteroids be considered as part of the standard care with photodynamic therapy?
Zarbin
Arch Ophthalmol 2006;124:563-571.
FULL TEXT
It's Time for a Clinical Trial to Investigate Intravitreal Triamcinolone for Macular Edema Due to Retinal Vein Occlusion: The SCORE Study
Scott and Ip
Arch Ophthalmol 2005;123:581-582.
FULL TEXT
|
