Intravitreal triamcinolone acetonide as treatment of macular edema in central retinal vein occlusion

PURPOSE: To report the clinical outcome of a patient receiving an intravitreal injection of triamcinolone acetonide as treatment of bilateral, long-standing, cystoid macular edema due to central retinal vein occlusion. METHODS: A 70-years-old patient suffering from bilateral central retinal vein occlusion for 2 years and 1.5 years, respectively, received transconjunctivally an intravitreal injection of 25 mg of crystalline triamcinolone acetonide in each eye, with 10 weeks between injections. RESULTS: During the follow-up period of 4 months (OD) and 6 weeks (OS), respectively, visual acuity increased from 0.05 to 0.25 in his right eye and from 0.125 to 0.25 in his left eye. Fluorescein angiography showed a decrease of fluorescein leakage in the macular area. CONCLUSIONS: Intravitreal injection of triamcinolone acetonide may be a therapeutic option for long-standing cystoid macular edema due to central retinal vein occlusion.     

Intravitreal triamcinolone acetonide for treatment of intraocular proliferative, exudative, and neovascular diseases

Within the last three years, triamcinolone acetonide has increasingly been applied intravitreally as treatment option for various intraocular neovascular edematous and proliferative disorders. The best response in terms of gain in visual acuity after the intravitreal injection of triamcinolone acetonide was found in eyes with intraretinal edematous diseases such as diffuse diabetic macular edema, branch retinal vein occlusion, central retinal vein occlusion, and pseudophakic cystoid macular edema. Visual acuity increased and degree of intraocular inflammation decreased in eyes with various types of non-infectious uveitis including acute or chronic sympathetic ophthalmia and Adamantiadis-Behcet's disease. Intravitreal triamcinolone may be useful as angiostatic therapy in eyes with iris neovascularization and proliferative ischemic retinopathies. Possibly, intravitreal triamcinolone may be helpful as adjunct therapy for exudative age-related macular degeneration, possibly in combination with photodynamic therapy. In eyes with chronic, therapy resistant, ocular hypotony, intravitreal triamcinolone can induce an increase in intraocular pressure and may stabilize the eye. The complications of intravitreal triamcinolone therapy include secondary ocular hypertension in about 40% of the eyes injected, cataractogenesis, postoperative infectious and non-infectious endophthalmitis, and pseudo-endophthalmitis. Intravitreal triamcinolone injection can be combined with other intraocular surgeries including cataract surgery. Cataract surgery performed some months after the injection does not show a markedly elevated rate of complications. If vision increases and eventually decreases again after an intravitreal triamcinolone acetonide injection, the injection can be repeated. The duration of the effect of a single intravitreal injection of triamcinolone depended on the dosage given. Given in a dosage of about 20mg to non-vitrectomized eyes, the duration of the effect and of the side-effects was 6-9 months. Intravitreal triamcinolone acetonide may offer a possibility for adjunctive treatment of intraocular edematous and neovascular disorders. One has to take into account the side-effects and the lack of long-term follow-up observations.     

Epiretinal deposit of triamcinolone acetonide at the posterior pole after intravitreal injection.

The authors investigated possible toxic side effects of epiretinal triamcinolone acetonide deposits at the posterior pole after an intravitreal injection in both a vitrectomized and a non-vitrectomized eye. The vitrectomized eye developed massive epiretinal triamcinolone acetonide deposits at the posterior pole that were less pronounced in the non-vitrectomized eye. After resolution of the deposits, no morphologic signs of retinal toxicity were apparent. Mild scattered visual field defects did not correlate with the localization of the triamcinolone acetonide deposits. However, because recent in vitro studies indicate potential cytotoxicity, patients should be instructed to keep their heads in an upright position after intravitreal triamcinolone acetonide injection to avoid deposits at the posterior pole.     

Exacerbation of central serous chorioretinopathy following intravitreal triamcinolone injection

Background  This report describes a case of central serous chorioretinopathy following intravitreal triamcinolone acetonide injection. Methods  A 42-year-old man presented with a 4-month history of decreased visual acuity (0.4) in his left eye. The left eye demonstrated macular edema due to branch retinal vein occlusion. Triamcinolone acetonide 4 mg/ 0.1 mL was injected intravitreally to treat the macular edema. Results  Pigmentary retinal discoloration, retinal pigment epithelium leakage and a slight neurosensorial detachment with cystoid macular edema at the temporal macula were present prior to intravitreal triamcinolone injection. Three weeks after injection, visual acuity had decreased to 0.2 and metamorphopsies appeared in the left eye. A sharply demarcated serous macular elevation and a progressively increasing hyperfluorescence of the pre-existing leakage point led to the diagnosis of “exacerbation of the pre-existing asymptomatic central serous chorioretinopathy” following intravitreal triamcinolone injection. Macular elevation spontaneously resolved by the 4th month post-injection. At the 6th month, the patient experienced recurrence of a small serous detachment at the temporal macula. Conclusion  Central serous chorioretinopathy exacerbation may arise as a complication of intravitreal triamcinolone acetonide injection.     

Triamcinolone acetonide facilitates removal of the epiretinal membrane and separation of the residual vitreous cortex in highly myopic eyes with retinal detachment due to a macular hole

PURPOSE: To study the usefulness of intravitreal triamcinolone acetonide injection during vitrectomy in highly myopic eyes with retinal detachment due to a macular hole. METHODS: Pars plana vitrectomy was performed in 6 patients with retinal detachment resulting from a highly myopic eye with a macular hole. After separation of the posterior hyaloid and removal of any visible epiretinal membrane, triamcinolone acetonide was injected over the posterior pole. Excised specimens were evaluated by transmission electron microscopy. RESULTS: Upon injection of triamcinolone acetonide, the entire epiretinal membrane and residual vitreous cortex could be visualized in all patients. The epiretinal membrane and residual posterior vitreous cortex were completely removed. Successful reattachment was performed without retinal damage in all cases. Electron microscopy revealed a cellular epiretinal membrane within a collagenous matrix lining the smooth internal surface of the internal limiting membrane. No complications related to the use of triamcinolone acetonide were encountered. CONCLUSION: Intraoperative visualization of the epiretinal membrane and residual posterior vitreous cortex with triamcinolone acetonide was found to be a useful adjunct to vitrectomy. Using triamcinolone acetonide during vitrectomy may facilitate both removal of the epiretinal membrane around the macular hole and separation of the residual vitreous cortex from the retina in highly myopic eyes with retinal detachment.     

Treatment of oedematous,proliferative and neovascular diseases by intravitreal triamcinolone acetonide

BACKGROUND: Recent studies have suggested that intravitreal triamcinolone acetonide may be a therapeutical possibility for treating of various intraocular neovascular, oedematous and proliferative diseases. METHODS AND RESULTS: Gain in visual acuity was relatively highest for eyes with intraretinal oedematous diseases such as diffuse diabetic macular oedema and various types of cystoid macular oedema due to reasons such as retinal venous occlusions and uveitis. Intravitreal triamcinolone may be useful as angiostatic therapy in eyes with iris neovascularisation and proliferative ischaemic retinopathies. Possibly, intravitreal triamcinolone may be helpful for exudative age-related macular degeneration. In eyes with chronic therapy resistant ocular hypotony, intravitreal triamcinolone can induce an increase in intraocular pressure. The role of intravitreal triamcinolone as adjunctive treatment of proliferative vitreoretinopathy has not been determined so far. Complications of intravitreal triamcinolone include secondary ocular hypertension in about 50 % of the eyes injected, with one per cent of the eyes necessitating antiglaucomatous filtrating surgery; a cataractogenic effect; and postoperative infectious endophthalmitis. Long-term studies of more than 3 years follow-up have been missing so far, so that there is no reliable information on long-term complications. The injection can be combined with cataract surgery. Cataract surgery performed some months after the injection did not show a markedly elevated rate of complications. If vision increases after the intravitreal triamcinolone injection, the injection can be repeated. The duration of the effect of a single intravitreal injection of triamcinolone ranges between 2 and 9 months. Triamcinolone acetonide was detected in the aqueous humour nine months after an intravitreal injection of 25 mg. CONCLUSIONS: Intravitreal triamcinolone acetonide may offer a possibility for adjunctive treatment of intraocular oedematous, neovascular and proliferative diseases.     

Opaque coating of an intraocular lens and regression of iris neovascularization following injection of triamcinolone acetonide into the anterior chamber

A pseudophakic patient presented with a vitreous haemorrhage and iris neovascularization associated with proliferative diabetic retinopathy. Vitrectomy with panretinal photocoagulation and intraocular gas tamponade of an iatrogenic break was performed. As an alternative to intravitreal injection into a gas-filled eye, triamcinolone acetonide was injected into the anterior chamber. Postoperatively, the visual acuity was reduced to light perception by an opaque coating of triamcinolone particles on the intraocular lens and iris which resolved over 2 months. By 4 months, the iris neovascularization had regressed completely. The use of intracameral triamcinolone in pseudophakic eyes may be associated with a transient loss of vision and prevent fundal visualization owing to triamcinolone coating of the intraocular lens.     

Periocular abscess caused by <Emphasis Type="Italic">Pseudallescheria boydii</Emphasis> after a posterior subtenon injection of triamcinolone acetonide

Background A posterior subtenon injection of triamcinolone acetonide is an alternative to intravitreal injection in diabetic macular edema and is known to have fewer vision-threatening complications. Here, we report a case of periocular abscess following posterior subtenon injection of triamcinolone.Methods A 62-year-old woman who had diabetic macular edema and disc neovascularization underwent a posterior subtenon injection of triamcinolone acetonide and panretinal laser photocoagulation. One month later a periocular abscess was noted in the inferotemporal area adjacent to the scleral wall. Pus was removed by fine-needle aspiration, and microbiologic cultures identified Pseudallescheria boydii. The patient was given systemic and subconjunctival treatment with itraconazole. However, conjunctival infection and anterior chamber inflammation worsened, and another posterior subtenon abscess was found.Results Despite long-term systemic and topical itraconazole therapy, retinal detachment and vitreous opacity were shown on B-scan, and atrophic bulbi resulted.Conclusions Pseudallescheria boydii infection of the eye and orbit can result in a poor visual outcome. Prompt surgical debridement and drainage of the abscess, along with appropriate antifungal therapy based on susceptibility testing, must be mandatory.     

Intravitreal triamcinolone acetonide in Vogt-Koyanagi-Harada syndrome

PURPOSE: To report the results of intravitreal triamcinolone acetonide in two eyes of a patient with Vogt-Koyanagi-Harada syndrome. METHODS: A 24-year-old woman with Vogt-Koyanagi-Harada syndrome was treated with a single 4-mg dose of intravitreal injection of triamcinolone acetonide in both eyes. RESULTS: On the seventh day after injection, visual acuity improved from 20/50 to 20/20 in the right eye and from 20/100 to 20/32 in the left. One month after injection, visual acuity was 20/20 in the right eye and 20/32 in the left, and fluorescein angiography showed that serous detachment had almost completely resorbed. The ocular examination remained stable during the 8-month follow-up period. CONCLUSIONS: In this study, a prompt improvement in the clinical picture of a patient with Vogt-Koyanagi-Harada syndrome after intravitreal triamcinolone acetonide injection was described. The results suggest that intravitreal triamcinolone acetonide injection may be an additional tool in the treatment of Vogt-Koyanagi-Harada syndrome.     

Intravitreal versus posterior subtenon injection of triamcinolone acetonide for diabetic macular edema

PURPOSE: To compare the short-term effects of intravitreal versus posterior subtenon injection of triamcinolone acetonide for diabetic macular edema. METHODS: This is a prospective and interventional study. Sixty eyes of 60 patients who had diffuse diabetic macular edema were assigned to receive a single intravitreal injection (4 mg) or a single posterior subtenon injection (40 mg) of triamcinolone acetonide. The central retinal thickness was measured using optical coherent tomography before injection and at 1 and 3 months after injection. Visual acuity and intraocular pressure (IOP) were also measured. RESULTS: Both intravitreal and posterior subtenon injections of triamcinolone acetonide resulted in significant improvements in visual acuity at 1 month and 3 months after injection. Both groups resulted in a significant decrease in central macular thickness (CMT) at 1 month and 3 months post-injection. IOP in the intravitreal injection group was significantly higher than in the posterior subtenon injection group at 3 months after injection. CONCLUSIONS: The posterior subtenon injection of triamcinolone acetonide had a comparable effect to the intravitreal triamcinolone injection and showed a lower risk of elevated IOP. Posterior subtenon injection of triamcinolone acetonide may be a good alternative for the treatment of diffuse diabetic macular edema.     

Cataract surgery combined with intravitreal injection of triamcinolone acetonide

PURPOSE: To evaluate whether the addition of cataract surgery to an intravitreal injection of triamcinolone acetonide markedly increases frequency and spectrum of complications. METHODS: The comparative nonrandomized clinical interventional investigation included a study group of 60 eyes (56 patients) undergoing cataract surgery and additionally receiving an intravitreal injection of about 20 mg of triamcinolone acetonide and a triamcinolone control group of 290 eyes (262 patients) that consecutively received an intravitreal injection of about 20 mg triamcinolone acetonide without cataract surgery. Reasons for intravitreal injection of triamcinolone acetonide were exudative age-related macular degeneration (n=228; 65%), diffuse diabetic macular edema (n=94; 27%), central retinal vein occlusion (n=17; 5%), and branch retinal vein occlusion (n=11; 3%). Mean follow-up was 8.6+/-6.8 months. A second control group included 1068 patients (1068 eyes) who consecutively underwent routine cataract surgery without intravitreal injection. RESULTS: Study group and triamcinolone control group did not vary significantly in best visual acuity during follow-up (p=0.08), final visual acuity at the end of follow-up (p=0.30), maximal intraocular pressure during follow-up (p=0.99), frequency of an intraocular pressure higher than 21 mmHg (p=0.66), and intraocular pressure at the end of follow-up (p=0.06). Postoperative infectious endophthalmitis, wound leakage or other corneal wound healing problems, persisting corneal endothelial decompensation, rhegmatogenous retinal detachment, marked postoperative pain, or a clinically significant decentration of the intraocular lens were not observed. Study group and the non-triamcinolone control group did not vary significantly in the rate of posterior lens capsule rupture (p=0.11), postoperative infectious endophthalmitis, and persisting postoperative corneal endothelial decompensation. CONCLUSIONS: The addition of cataract surgery to an intravitreal injection of triamcinolone acetonide may not markedly increase amount and frequency of side effects and complications of intravitreal triamcinolone acetonide. No safe conclusions can be reached regarding differences in frequency of postoperative infectious endophthalmitis.     

Difference in clearance of intravitreal triamcinolone acetonide between vitrectomized and nonvitrectomized eyes

PURPOSE: To study the difference in clearance of intravitreal triamcinolone acetonide quantitatively between vitrectomized and nonvitrectomized eyes. METHODS: Eighty-four eyes of 42 rabbits were divided in 2 groups: 42 right eyes underwent standard pars plana vitrectomy (vitrectomized group), and 42 left eyes were not operated on (nonvitrectomized group). All eyes received intravitreal injections with 0.1 mL (0.3 mg) of triamcinolone acetonide. Every 12 eyes were obtained by killing 6 rabbits 1, 2, 4, 7, 12, 20, or 30 days after intravitreal injection. Each eye was enucleated and immediately frozen at -70 degrees C. The frozen vitreous was prepared for measuring the concentration of triamcinolone acetonide. Triamcinolone acetonide was quantified by high-performance liquid chromatography and ultraviolet absorbance detection. RESULTS: After 30 days, triamcinolone acetonide was detected only in 1 eye (0.22 microg/mL) in the vitrectomized group compared with 4 of 6 eyes (0.92 +/- 1.25 microg/mL) in the nonvitrectomized group. The coefficient of logarithmic regression was -0.12 in the vitrectomized group and -0.08 in the nonvitrectomized group. Triamcinolone acetonide decreased 1.5 times more rapidly in the vitrectomized group than in the nonvitrectomized group. The half-life of triamcinolone acetonide was 1.57 days in the vitrectomized group and 2.89 days in the nonvitrectomized group. CONCLUSION: Intravitreal triamcinolone acetonide decreases more rapidly in the vitrectomized eye than in the nonvitrectomized eye. Therefore, the faster clearance of intravitreal triamcinolone acetonide must be considered when planning intravitreal injection of triamcinolone acetonide in the vitrectomized eye.     

Ultrasound biomicroscopy study of vitreous incarceration subsequent to intravitreal injections

ObjectiveTo study the existence of vitreous incarceration by ultrasound biomicroscopy (UBM) at the pars plana after direct intravitreal injection of triamcinolone acetonide ± bevacizumab without anterior chamber paracentesis.DesignInterventional case series.ParticipantsPatients undergoing intravitreal injection of triamcinolone acetonide with or without intravitreal bevacizumab.MethodsIn 21 eyes, the existence of vitreous incarceration at the pars plana site of intravitreal injection of 0.05 mL of drug was studied by UBM (50 MHz probe of the VUmax, Sonomed, NY), the day after surgery, by 1 technician. The reason for injection was diabetic retinopathy in 12 (57.1%) eyes; age-related macular degeneration in 6 (28.6%) eyes; branch retinal vein occlusion in 2 (9.5%) eyes; and choroiditis in 1 eye (4.8%). In 1 eye, only triamcinolone acetonide was injected, and in the other eyes, bevacizumab mixed with triamcinolone acetonide was injected.ResultsWe studied 21 eyes in 13 patients. Of the subjects, 61.5% were male. The mean age of the patients was 62.2 years. On the day after intravitreal injection of the drug, vitreous incarceration into the pars plana site was detected by UBM in 42.9% of the eyes.ConclusionVitreous incarceration exists after intravitreal injection of drug, but its clinical importance is still unknown. Further long-term prospective studies are recommended.     

Frequency of cataract surgery after intravitreal injection of high-dosage triamcinolone acetonide

PURPOSE: To evaluate the frequency of cataract surgery after intravitreal injection of high-dosage triamcinolone acetonide in elderly patients. METHODS: This clinical interventional case series study included 144 phakic eyes that consecutively received an intravitreal injection of about 20 mg triamcinolone acetonide for diffuse diabetic macular edema (n=42 eyes), exudative age-related macular degeneration (n=98), and branch retinal vein occlusion (n=4). Mean age was 72.3-/+8.9 years. Mean follow-up was 11.0-/+6.8 months (median, 8.8 months; range, 3 to 35.5 months). Reinjections were carried out in 12 (8.3%) eyes. RESULTS: Cataract surgery was performed in 20 (13.9%) eyes 17.4-/+9.1 months (median, 12.7 months; range, 8.0 to 35.5 months) after the first intravitreal injection. Out of the 20 eyes undergoing cataract surgery, 19 (95%) eyes had received one intravitreal injection, and 1 (5%) eye had received two previous injections. CONCLUSIONS: In the elderly population of patients with exudative age-related macular degeneration, diffuse diabetic macular edema, or branch retinal vein occlusion, intravitreal high-dosage injection of triamcinolone acetonide leads to clinically significant cataract with eventual cataract surgery in about 15% to 20% of eyes within about 1 year after the intravitreal injection.     

Intravitreal triamcinolone acetonide for treatment of intraocular oedematous and neovascular diseases

Intravitreal triamcinolone acetonide (IVTA) has increasingly been applied as treatment for various intraocular neovascular and oedematous diseases. Comparing the various diseases with respect to effect and side-effects of the treatment, the best response in terms of gain in visual acuity (VA) has been achieved for intraretinal oedematous diseases such as diffuse diabetic macular oedema, branch retinal vein occlusion, central retinal vein occlusion and pseudophakic cystoid macular oedema. In eyes with various types of non-infectious uveitis, including acute or chronic sympathetic ophthalmia and Adamantiadis-Behcet's disease, VA increased and the degree of intraocular inflammation decreased. Some studies have suggested that intravitreal triamcinolone may be useful as angiostatic therapy in eyes with iris neovascularization and proliferative ischaemic retinopathies. Intravitreal triamcinolone may possibly be helpful as adjunct therapy for exudative age-related macular degeneration (AMD), particularly in combination with photodynamic therapy. In eyes with chronic, therapy-resistant ocular hypotony, intravitreal triamcinolone can induce an increase in intraocular pressure (IOP) and may stabilize the eye. The complications of intravitreal triamcinolone therapy include: secondary ocular hypertension in about 40% of the eyes injected; medically uncontrollable high IOP leading to antiglaucomatous surgery in about 1-2% of the eyes; posterior subcapsular cataract and nuclear cataract leading to cataract surgery in about 15-20% of elderly patients within 1 year of injection; postoperative infectious endophthalmitis occurring at a rate of about one per 1000; non-infectious endophthalmitis, perhaps due to a reaction to the solvent agent, and pseudo-endophthalmitis with triamcinolone acetonide crystals appearing in the anterior chamber. Intravitreal triamcinolone injection can be combined with other intraocular surgeries, including cataract surgery, particularly in eyes with iris neovascularization. Cataract surgery performed some months after the injection does not show a markedly elevated complication rate. The injection may be repeated if the resultant benefits decrease after the initial IVTA injection. In non-vitrectomized eyes, the duration of the effect and side-effects of a single intravitreal injection of triamcinolone is about 6-9 months for a dosage of about 20 mg, and about 2-4 months for a dosage of 4 mg. So far, it has remained unclear whether the solvent agent should be removed, and if so, how.     

曲安奈德玻璃体腔注射治疗脉络膜脱离型视网膜脱离的初步研究

目的探讨玻璃体腔注射曲安奈德治疗脉络膜脱离型视网膜脱离的疗效及安全性。方法选择未经有效治疗的脉络膜脱离型视网膜脱离患者,于手术前经睫状体平坦部向玻璃体腔内注入曲安奈德混悬液0．1ml(4mg),注药后观察葡萄膜炎反应及脉络膜脱离消失情况,并于5—10d后行视网膜脱离复位手术。结果有葡萄膜炎反应的13只眼其症状均不同程度减轻,裂孔检出率由注药前的2／13只眼提高至注药后的7／13只眼,绝大多数脉络膜脱离眼于注药后10d内消失,5只眼采用巩膜扣带术,6只眼采用玻璃体切除联合眼内填充术,2例患者放弃手术治疗。手术后平均随访4．45个月,接受手术者最终视网膜全部复位,无1例出现全身应用糖皮质激素的副作用。结论玻璃体腔注射曲安奈德能迅速、安全、有效地治疗脉络膜脱离型视网膜脱离,减轻葡萄膜炎反应,提高脉络膜脱离型视网膜脱离的手术复位率。(中华眼科杂志,2005,41：606-609)     

Regression of Optic Nerve Head Neovascularization in Proliferative Diabetic Retinopathy After Intravitreal Triamcinolone: Regression of Diabetic Optic Disc Neovascularization After Intravitreal Triamcinolone

The aim of this study is to report the clinical outcome of a diabetic patient with optic nerve head neovascularization treated with an intravitreal injection of triamcinolone acetonide. A 52-year-old patient presented with clinically significant diffuse macular edema and optic nerve head neovascularization due to proliferative diabetic retinopathy in her right eye. Despite grid laser photocoagulation in the macular region macular edema progressed and visual acuity declined. The patient received a single intravitreal injection of 4 mg triamcinolone acetonide with topical anesthesia. After injection of triamcinolone acetonide visual acuity increased and macular edema decreased. Furthermore optic nerve head neovascularization had markedly regressed. No complication was observed during follow-up period. Intravitreal injection of triamcinolone acetonide may be useful for treatment of optic nerve head neovascularization in patients with proliferative diabetic retinopathy.     

Endophthalmitis with retinal necrosis following intravitreal triamcinolone acetonide injection

A 69-year-old man with heterozygote factor V Leiden mutation and a history of central retinal vein occlusion in his left eye complained of decreased visual acuity in his right eye. Macular edema and ischemic CRVO were diagnosed. Following an intravitreal injection of 4 mg triamcinolone acetonide, endophthalmitis and necrotizing retinopathy developed, clinically resembling necrotizing herpetic retinopathies as have been described in immuno-compromised patients. An endogenous viral infection due to a steroid-induced immune suppression may be another complication of intravitreal injections of corticosteroids.     

Intravitreal triamcinolone acetonide in sympathetic ophthalmia

Purpose To report the result of intravitreal triamcinolone acetonide in the treatment of sympathetic ophthalmia.Methods A 29-year-old woman who suffered from sympathetic ophthalmia and who was being treated with systemic corticosteroid therapy received an intravitreal injection of 4 mg of triamcinolone acetonide.Results By the 15th day after injection visual acuity had improved from 20/200 to 20/40 and serous retinal detachment had almost completely resorbed. Systemic corticosteroid therapy was reduced sequentially. By the third month after injection, the patient was in clinical remission. Her visual acuity was 20/20 and no serous detachment was observed.Conclusions In this study, short-term improvement in the clinical picture of a patient with sympathetic ophthalmia after intravitreal triamcinolone acetonide injection was described. The results suggest that intravitreal triamcinolone acetonide injection may be an additional tool in the treatment of sympathetic ophthalmia.The authors have no proprietary interest in the material used in this study.     

Intravitreal triamcinolone in the treatment of serous retinal detachment in Vogt-Koyanagi-Harada syndrome

PURPOSE: To report the use of intravitreal injection of triamcinolone acetonide during the acute phase of Vogt-Koyanagi-Harada disease. DESIGN: Prospective interventional case series. METHODS: Three eyes from two patients at the acute phase of Vogt-Koyanagi-Harada disease with serous retinal detachments were treated with a 4-mg intravitreal injection of triamcinolone acetonide. The following variables were evaluated: visual acuity, intraocular pressure, and height of the serous retinal detachment using optical coherence tomography. RESULTS: The optical coherence tomography images showed a marked decrease in the retinal detachment in the first week after the injection with subsequent return to normal retinal thickness in all eyes. CONCLUSIONS: Intravitreal triamcinolone acetonide provides short-term improvement in visual acuity and serous retinal detachments associated with Vogt-Koyanagi-Harada disease. These findings should be followed by future studies to evaluate long-term effects.