Gentil, R

Gomes, N

Leite, R

Mendes, J

Mendonça, L

Sousa, K

Vaz, F

English

Institutional repository of Hospital de Braga

TRIAMCINOLONE INTRAVITREAL INJECTION RESULTS IN PREVIOUSLY VITRECTOMIZED EYES:  LONGER EFFECT THAN WE EXPECTED?  KEISSY SOUSA, RITA GENTIL, LUÍS MENDONÇA, RICARDO LEITE, JOSÉ MENDES, FERNANDO VAZ, NUNO GOMES HOSPITAL DE BRAGA  INTRODUCTION The treatment of macular edema has significantly improved in recent years.1-4 Intravitreal  triamcinolone acetonide (IVTA) has been shown to improve visual acuity (VA) and reduce  central macular thickness (CMT) more effectively than laser treatment in different pathologies2,3.   IVTA is associated with a low incidence of surgical complications but with some well-known  side effects (increase in intraocular pressure, cataract development).1-4 Several aspects of the    off-label use of 4 mg of triamcinolone need to be clarified.  The recurrence of DMO is related to the disappearance of triamcinolone from the vitreous: a mean elimination half-life of 18.6 days has been found and it was estimated that 4 mg of triamcinolone would last in the vitreous for 3 months.4 In theory, the half-life of this drug should be smaller in previously vitrectomized eyes  due to the lack of the vitreous reservoir and a faster wash-out from the vitreous cavity.  PURPOSE To analyse the effect of IVTA on CMT in previously vitrectomized eyes.   METHODS      Retrospective study.  Hospital de Braga, Ophthalmology Department  Eyes with macular edema that had previously underwent 23G pars plana vitrectomy.  The following parameters were analyzed before and after IVTA:: •  Best Corrected Visual Acuity (BCVA),  •  IntraOcular Pressure (IOP), •  Mean CMT using Optical Coherence Tomography (Cirrus TM HD-OCT Zeiss Meditec®). We compared the change in mean CMT and its effect time.  Statistical analysis were performed using paired-sample t-test.  RESULTS 11 pseudophakic eyes of 9 patients were included as shown below.                                        Central Macular Thickness-lowering effect of triamcinolone in vitrectomized eyes lasted a mean (±SD) of 11.62±3.46 weeks.                       Age (years) Mean (±SD) 68.2 (±8.65) Range 57-81 Sex (n) Male 4 Female 5 Eye (n) Right Eye 6 Left Eye 5 Mean time between PPV and IVTA (months) Mean (±SD) 11.12 (±4.5) Range 2.3 – 14.8 Cause Diabetic Macular Edema 9 Trauma 1 Rhegmatogenous Retinal Detachment 1 Before IVTA After IVTA paired-sample t-test Intraocular Pressure (mmHg) 16.45±2.58 19.85±3.34 0.0041 Visual Acuity (decimal scale) 0.22±0.17 0.28±0.19 0.1329 Central Macular Thickness 488.91±144.7 1st IVTA: 228.64±170,79 0.0012 2nd IVTA: 355±121 0.0315 (vs. baseline) REFERENCES 1.  Abraldes MJ, Fernández M, Gómez-Ulla F. Intravitreal Triamcinolone in Diabetic Retinopathy. Current Diabetes Reviews. 2009;5:18-25. 2.  Spandau U, Derse M, Schmitz-Valckenberg P, Papoulis C, Jonas J. Dosage dependency of intravitreal triamcinolone acetonide as treatment for diabetic macular oedema. Br J Ophthalmol. 2005;89:999-1003. 3.  Michael S. Intravitreal Injection of Triamcinolone. Diabetes Care. 2004;27(7). 4.  Longo A. Intravitreal triamcinolone for diffuse diabetic macular oedema. Br J Ophthalmol. 2006;90:1079-80. CONCLUSIONS Triamcinolone should be considered in the treatment of patients with persistent macular edema even in vitrectomized eyes. Central Macular Thickness-lowering effect of triamcinolone in vitrectomized eyes approached the time-range of 12 to 14 weeks set for non-vitrectomized eyes.                   CONCLUSIONS Triamcinolone should be considered in the treatment of patients with persistent macular edema even in vitrectomized eyes. Central Macular Thickness-lowering effect of triamcinolone in vitrectomized eyes approached the time-range of 12 to 14 weeks set for non-vitrectomized eyes.    0 100 200 300 400 500 600 700 1 2 3 4 5 6 7 8 9 10 11 CMT Patient CMT before and after IVTA per patient Before IVTA After 1st IVTA After 2nd IVTA 

Triamcinolone Intravitreal Injection Results in Previously Vitrectomized Eyes: Longer Effect than We Expected?

http://repositorio.hospitaldebraga.pt/bitstream/10400.23/825/1/poster.pdf

Triamcinolone Intravitreal Injection Results in Previously Vitrectomized Eyes: Longer Effect than We Expected?

Abstract

Similar works

Full text

Available Versions

Institutional repository of Hospital de Braga