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Ahmed Sallam, MD, FRCS; Richard M. Comer, MD, FRCOphth; John H. Chang, MD; John R. Grigg, FRACO, FRACS; Richard Andrews, FRCOphth; Peter J. McCluskey, MD, FRACO; Susan Lightman, PhD, FRCOphth

Arch Ophthalmol. 2008;126(2):200-205.

Objectives  To evaluate the short-term safety and efficacy of intravitreal (IV) triamcinolone acetonide (TA) for treating pediatric cystoid macular edema (CME) secondary to noninfectious uveitis.

Methods  A retrospective noncomparative interventional case series. The medical records of 15 consecutive children (16 eyes) with uveitic CME treated with IVTA (2 or 4 mg) were reviewed. Data collected included details of uveitis, CME, visual acuity, intraocular pressure, and cataract development. The median follow-up time was 16 months (range, 9-36 months).

Results  Resolution of CME was achieved in all of the treated eyes. The median time taken for CME to resolve was 3 weeks (range, 1-24 weeks). The mean improvement of visual acuity after IVTA was 0.6 logarithm of the minimum angle of resolution. Following initial response to IVTA, CME relapsed in 5 eyes (31%) after a median time of 7 months (range, 3-13 months). The most common adverse effect was increased intraocular pressure, with an increase of more than 15 mm Hg in 5 eyes (31%). Steroid-induced cataract was observed in 6 of 11 phakic eyes (55%).

Conclusions  We found that IVTA is efficacious in the treatment of uveitic CME in children and results in CME resolution and visual acuity improvement. As in adults, treatment in children may be associated with elevated intraocular pressure and cataract.

Author Affiliations: Department of Clinical Ophthalmology, Institute of Ophthalmology, Moorfields Eye Hospital, London, England (Drs Sallam, Comer, Andrews, and Lightman); and Department of Ophthalmology, Liverpool Hospital (Drs Chang and McCluskey), and Save Sight Institute, University of Sydney, Sydney Eye Hospital (Dr Grigg), Sydney, Australia.

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