Intravitreal triamcinolone acetonide for the treatment of immune recovery uveitis macular edema

Ophthalmology. 2007 Feb;114(2):334-9. doi: 10.1016/j.ophtha.2006.07.013.

Abstract

Purpose: To evaluate the use of intravitreal triamcinolone (IVTA) for the treatment of macular edema secondary to immune recovery uveitis (IRU) in patients with AIDS.

Design: Prospective, consecutive, interventional case series.

Participants: Eight eyes of 7 patients receiving 13 injections.

Methods: Prospective, consecutive, interventional case series of 13 injections involving 8 eyes in 7 patients who underwent an intravitreal injection of 20 mg decanted triamcinolone acetate for fluorescein angiographically proven IRU-related macular edema.

Main outcome measures: The primary outcome measure was vision (using the Early Treatment Diabetic Retinopathy Study chart). Other outcome measures included fluorescein angiography and optical coherence tomography.

Results: Visual acuity improved at all time points and was statistically significant at the 1-month and 3-month follow-up examinations. The average visual improvement was 3 lines at 3 months. Retinal volume and thickness improvement were statistically significant at all time points. All patients had a minimum follow-up of 9 months, and there were no cases of cytomegalovirus reactivation.

Conclusions: Previous studies showed that treatment with sub-Tenon repository steroids for the treatment of macular edema of IRU was only marginally effective. However, the current study shows that IVTA can be an effective short-term treatment for macular edema secondary to IRU in patients with AIDS. Longer follow-up is needed to assess the durability of the effect and to monitor for longer-term complications and outcomes.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • AIDS-Related Opportunistic Infections / drug therapy
  • AIDS-Related Opportunistic Infections / immunology
  • Adult
  • CD4 Lymphocyte Count
  • CD4-Positive T-Lymphocytes / immunology*
  • Cytomegalovirus Retinitis / drug therapy
  • Cytomegalovirus Retinitis / immunology
  • Female
  • Fluorescein Angiography
  • Glucocorticoids / therapeutic use*
  • Humans
  • Injections
  • Macular Edema / diagnosis
  • Macular Edema / drug therapy*
  • Macular Edema / immunology
  • Male
  • Middle Aged
  • Prospective Studies
  • Tomography, Optical Coherence
  • Triamcinolone Acetonide / therapeutic use*
  • Uveitis / diagnosis
  • Uveitis / drug therapy*
  • Uveitis / immunology
  • Visual Acuity
  • Vitreous Body

Substances

  • Glucocorticoids
  • Triamcinolone Acetonide