Intravitreal triamcinolone for macular edema in Lyme disease

Graefes Arch Clin Exp Ophthalmol. 2008 Mar;246(3):457-8. doi: 10.1007/s00417-007-0740-0. Epub 2008 Jan 12.

Abstract

Background: To describe the outcome in a patient with macular edema caused by Lyme disease treated with injection of 4 mg intravitreal triamcinolone.

Methods: The patient, 2 years after systemic Lyme disease treated with doxycycline for 4 weeks, developed macular edema with serous retinal detachment in one eye (visual acuity: 0.6). After unsuccessful therapy with intravenous ceftriaxone, indomethacin and acetazolamide, 4 mg intravitreal triamcinolone (IVTA) was injected via the pars plana.

Results: Visual acuity improved to 1.0 and macular thickness recovered over 1 month. No changes were found in intraocular pressure. No recurrence of macular edema was seen after 2 years.

Conclusions: IVTA can restore visual acuity and reduce macular thickness in macular edema caused by Lyme disease. However, since borreliosis is a systemic disease, previous systemic antibiotic treatment is recommended.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Doxycycline / therapeutic use
  • Female
  • Fluorescein Angiography
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use*
  • Humans
  • Injections
  • Lyme Disease / complications*
  • Lyme Disease / drug therapy
  • Macular Edema / diagnosis
  • Macular Edema / drug therapy*
  • Macular Edema / etiology
  • Tomography, Optical Coherence
  • Triamcinolone Acetonide / administration & dosage
  • Triamcinolone Acetonide / therapeutic use*
  • Visual Acuity / drug effects
  • Vitreous Body

Substances

  • Anti-Bacterial Agents
  • Glucocorticoids
  • Triamcinolone Acetonide
  • Doxycycline