Original Paper

Intravitreal and Orbital Floor Triamcinolone Acetonide Injections in Noninfectious Uveitis: A Comparative Study
Martin Roesel, Matthias Gutfleisch, Carsten Heinz, Britta Heimes, Beatrix Zurek-Imhoff, Arnd Heiligenhaus

Department of Ophthalmology, St. Franziskus Hospital, University Duisburg-Essen, Münster, Germany

Address of Corresponding Author

Ophthalmic Res 2009;42:81-86 (DOI: 10.1159/000220600)

  Key Words

• Uveitis
• Triamcinolone
• Cystoid macular edema
• Immunosuppression
• Corticosteroids

  Abstract

Purpose: To compare the effect of orbital floor (OFTA) or intravitreal (IVTA) administration of triamcinolone acetonide on visual acuity and chronic cystoid macular edema (CME) in patients with uveitis. Methods: Retrospective study of patients suffering from chronic noninfectious uveitis in whom CME (n = 97) did not respond to systemic corticosteroids and/or immunosuppression combined with acetazolamide. Patients received a single injection of either IVTA (n = 48, group 1) or OFTA (n = 49, group 2). Best-corrected visual acuity, macular edema (fluorescein angiography), uveitis activity, ocular hypertension, and cataract formation were analyzed over the course of 1 year. Results: Improvement in visual acuity (2 lines, LogMAR) was noted in 50% (IVTA) and 34% (OFTA) after 3 months (p = 0.23), and in 18% (IVTA) and 20% (OFTA) after 12 months. CME improved in 100% (IVTA) and 76% (OFTA) of the eyes within the first month postoperatively (p = 0.36). Macular edema was reduced in 100% (group 1) and 20% (group 2) after 3 months (p < 0.01). At 1 year, cataract progression was noted in 68% (IVTA) and 27% (OFTA) (p < 0.01). Increased intraocular pressure (>21 mm Hg) was detected in 21% (IVTA) and 0% (OFTA) at 4 weeks (p < 0.01) after injection. Conclusion: Uveitic CME and visual acuity not responding to systemic immunosuppression and acetazolamide may improve after an IVTA and OFTA injection. The effect is mostly transient. While the IVTA injections were more effective for improving CME, ocular hypertension and cataracts developed more often.

Copyright © 2009 S. Karger AG, Basel

  Author Contacts

Arnd Heiligenhaus
Department of Ophthalmology, St. Franziskus Hospital
Hohenzollernring 74, DE-48145 Münster (Germany)
Tel. +49 251 933 080, Fax +49 251 933 0819
E-Mail arnd.heiligenhaus@uveitis-zentrum.de

  Article Information

Received: June 22, 2008
Accepted after revision: August 25, 2008
Published online: May 27, 2009
Number of Print Pages : 6
Number of Figures : 1, Number of Tables : 4, Number of References : 34