Original Paper

Repeated Intravitreal Injection of Triamcinolone for Exudative Age-Related Macular Degeneration
Jost B. Jonas, Ulrich H. Spandau, Bernd A. Kamppeter, Urs Vossmerbaeumer, Bjoern Harder

Department of Ophthalmology, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany

Address of Corresponding Author

Ophthalmic Res 2006;38:324-328 (DOI: 10.1159/000096226)

  Key Words

• Intravitreal triamcinolone acetonide
• Intravitreal steroids
• Age-related macular degeneration
• Intraocular neovascularization
• Macular disease

  Abstract

Background: Intravitreal triamcinolone acetonide has been discussed as treatment for exudative age-related macular degeneration (AMD). Objectives: To give an updated report on repeated intravitreal injections of triamcinolone acetonide (IVTA) for the treatment of exudative AMD. Methods: The case-series study included 24 patients (24 eyes) with progressive exudative AMD who had shown an increase in, or stabilization of, visual acuity after a first IVTA, and who eventually experienced a deterioration of visual acuity. The 24 (6.5%) eyes were selected out of a total group of 369 eyes who had received IVTA for exudative AMD within the last 5 years. All patients of the study received a second IVTA (approximately 20 mg) 3.7-38.5 months after the first injection. Main outcome measure was visual acuity. Results: After the first injection, best corrected visual acuity improved significantly (p = 0.001) from 0.75 ± 0.34 logMAR to a minimum of 0.58 ± 0.30 logMAR during follow-up, with 10 (42%) eyes improving in visual acuity by two or more Snellen lines. Towards the end of follow-up after the first injection, best corrected visual acuity decreased significantly (p = 0.03) compared with the baseline value. After the second injection, visual acuity did not change markedly from baseline to a mean maximal visual acuity during follow-up. Comparing the last postoperative examination at the end of the follow-up after the second IVTA with the preoperative examination, a significantly (p = 0.001) higher number of eyes lost in visual acuity [19 (79%) eyes] than gained in visual acuity [3 (12%) eyes]. Conclusions: In selected eyes with an increase in visual acuity after a first IVTA (20 mg), repeated IVTA temporarily stabilizes visual acuity with a drop in visual acuity towards the end of follow-up.

Copyright © 2006 S. Karger AG, Basel

  Author Contacts

Dr. J. Jonas
Universitäts-Augenklinik, Theodor-Kutzer-Ufer 1-3
DE-68167 Mannheim (Germany)
Tel. +49 621 383 2242, Fax +49 621 383 3803
E-Mail Jost.Jonas@augen.ma.uni-heidelberg.de

  Article Information

Received: December 12, 2005
Accepted after revision: June 6, 2006
Published online: October 13, 2006
Number of Print Pages : 5
Number of Figures : 0, Number of Tables : 1, Number of References : 36