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104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft 2006
Abstract
Abstract
SO.05.11 Parabulbar and intravitreal triamcinolone-acetonid-injection in patients with cystoid macular edema in inactive endogenous uveitis Gutfleisch M., Rösel M., Heinz C., Heiligenhaus A.
Department of Ophthalmology, St.-Franzsikus-Hospital Münster Objective: Recently, parabulbar (pb) and intraocular (io) injections with triamcinolone-acetonid have been suggested for the treatment of uveitis. In this study, the effect of pb and io TA injections on cystoid macular edema (CME) in patients with inactive uveitis was compared.
Methods: Monocenter, retrospective study in patients with endogenous uveitis. TA (Kenalog®) was injected pb (40mg) or intravitreal (4mg). CME (fluorescein angiography), activity of inflammation in the anterior chamber and vitreous, best-corrected visual acuity, intraocular pressure, and complications were analyzed during a 6-months follow-up period after the injection.
Results: Twenty-six patients with CME in inactive uveitis received TA injections (n=28). TA was given pb (n=11) or io (n=17). Systemic corticosteroids >10mg or immunosuppression, or high-dose topical corticosteroids were given in 64 % (7 out of 11) in the pb group, and in 88% (15 out of 17) of the io group. Improvement of CME after 3 to 6 months was noted in 3 out of 11 patients (27%) after pb TA injection, and in 15 out of 17 patients (88%) after io injection. After pb injection, vision did not improve in any of the patients, was unchanged in 8 (73%), and worsened in another 3 (27%); after io injection, vision improved in 6 (35%) patients, was unchanged in 8 (47%), and worsened in another 3 (18%). While ocular hypertension did not occur in any of the pb treated patients, it was noted in 6 patients from the io group. Cataract did not progress in any of the 11 phacic patients from the pb group, but progressed in 4 out of 14 phacic patients in the io group.
Conclusions: In patients with inactive endogenous uveitis, both the pb and io injection with TA may be helpful to improve CME. In this respect, the io TA injection was more effective than the pb application, but it was complicated more often by ocular hypertension and cataract progression.
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