Suprachoroidal triamcinolone in macular edema for patients with non-infectious uveitis resistant to subtenon triamcinolone

Abstract

Purpose

Uveitic macular edema is a serious complication of uveitis which if not properly managed can cause visual impairment. The study aimed to assess the response of uvetic macular edema to suprachoroidal triamcinolone injections for sub-Tenon triamcinolone acetonide resistant patients. The response was measured by changes in central macular thickness (CMT) and visual acuity (VA), with measurements taken before treatment, one and three months after treatment.

Design

Prospective Single Arm Clinical Study

Methods

The study included 9 patients with non-infectious uveitis treated with systemic steroids and immunosuppressant therapy. These patients had uveitic macular edema that persisted despite adequate control of intra-ocular inflammation and showed no response to posterior sub-tenon steroids injections. Suprachoroidal triamcinolone acetonide injection was considered for those patients; 4 mg was injected into the suprachoroidal space.

Results

The study involved 44.4 % males; the mean age was 35 years. The underlying etiologies included Vogt–Koyanagi–Harada (VKH) syndrome in three patients (33.3 %), pars planitis in four patients (44.5 %), and Behcet disease in two (22.2 %).

The mean central macular thickness CMT decreased from 556 µm to 270 µm, and LogMAR visual acuity improved from 0.876 to 0.470 over three months. Over three months, 8 patients showed a 40 % reduction in CMT, with >60 % decline in 3 patients. In terms of VA, 6 patients gained 2 lines and 2 patients gained 4 lines.

Conclusion

Suprachoroidal triamcinolone demonstrated a significant improvement in visual acuity and a reduction in CMT at one and three months in patients with non-infectious uveitis.