Objective: To observe the efficacy and safety of subconjunctival triamcinolone acetonide injections in the treatment of uveitic macular edema (UME).
Methods: A retrospective case series study. The clinical data of uveitis patients with macular edema were collected and analyzed at Peking Union Medical College Hospital from July 2009 to June 2014 with a minimum follow-up period of 6 months. The main outcome was central macular thickness (CMT) measured by optical coherence tomography at the 1st and the 3rd month after injection. The secondary outcomes included best corrected visual acuity (BCVA) at the 1st and the 3rd month, recurrence rate and intraocular pressure (IOP) within 6 months after injection.
Results: Thirty two patients (37 eyes) were included in the study. At the 1st month after the first injection, 24 of the 37 eyes (64.9%) showed an obvious reduction of CMT (at least 20%), among them 15 eyes (40.5%) showed a total resolution. The mean CMT decreased from (498.9 ± 211.9) µm at baseline to (392.4 ± 232.3) µm (t = -4.070, P < 0.01). The BCVA improved in 20 eyes (54.1%) and 15 eyes (40.5%) gained more than 0.2 log MAR unit. The mean BCVA increased from logMAR, 0.45 ± 0.29 at baseline to logMAR, 0.33 ± 0.30 (t = -4.835, P < 0.01). No statistically significant difference was found in mean CMT or BCVA in 23 eyes between the 1st and the 3rd month after injection. These eyes didn't receive any additional medications for improvement of the condition. Seven eyes (30.4%, 7/23) got a second injection because of relapse within 6 months after the first injection and the efficacy was good. The elevation of IOP over 21 mmHg (1 mmHg = 0.133 kPa) were observed in 9 eyes and 3 eyes after the first and the second injection respectively. All of them were well controlled by either topical IOP lowering drugs or removal of the subconjunctival TA deposition.
Conclusion: Subconjunctival injection of triamcinolone acetonide is an effective and safe method for uveitic macular edema.