Uveitic macular edema: efficacy and safety of subconjonctival triamcinolone injections

PurposeTriamcinolone acetonide is a prolonged‐release corticosteroid with a maximum effect until approximately 3 months. The aim of this work is to evaluate its effectiveness and side‐effects in uveitic macular edema treatment.MethodsThis is a single institution retrospective study. From October 2014 to September 2016, 44 eyes of 44 patients who had subconjunctival triamcinolone acetonide injections for an uveitic macular oedema were included. The main outcome measures were the best corrected visual acuity and the central macular thickness measured in optical coherence tomography (OCT). These parameters were evaluated at baseline, 1 month, 3 months, 6 months and 10 months after first injection. Intraocular pressure, introduction of anti glaucoma medication, and appearance of cataract during follow‐up were also notedResultsA statistically significant improvement of visual acuity was observed as early as one month, and the benefit continuing up to 10 months. Initial visual acuity was 0.59 ± 0.49 logMAR and 0.35 ± 0.43 logMAR at 10 months. Initial macular central thickness was 460 ±124 μm, it significantly decreased to 333 ±78 μm at 1 month. Macular thickness was rapidly reduced to 1 month, and then seems relatively stable up to 10 months. The mean intraocular pressure at baseline was 14.8 ± 3.6 mmHg and significantly increased at 1 month to 17.6 ± 6 mmHg and to 17.2 ± 4,3 mmHg at 3 months. There were 9 intra ocular hypertension cases (20%) treated with glaucoma medication. No filtration surgery was required. There was one case of cataract but no surgery.ConclusionsSubconjonctival triamcinolone acetonide injections thus provide a visual acuity gain and a decrease of uveitic macular oedema. They appear to be an alternative to intravitreal and subtenon injections, less invasive and easier to achieve.