title: Intravitreal reinjection of triamcinolone for exudative age-related macular degeneration.
abstract: OBJECTIVE
  To evaluate the outcome of repeated intravitreal injections of triamcinolone acetonide for the treatment of exudative age-related macular degeneration.
  
  
  METHODS
  This prospective, comparative nonrandomized clinical interventional study included 13 patients with progressive exudative age-related macular degeneration with occult, or predominantly occult, subfoveal neovascularization. All patients had shown an increase or stabilization of visual acuity after a first intravitreal injection of 25 mg of triamcinolone acetonide. They received a second intravitreal injection of 25 mg of triamcinolone acetonide 3.1 to 18 months after the first injection. Mean +/- SD follow-up time after the second injection was 5.2 +/- 3.6 months (median, 5.3 months). A control group included 24 patients with exudative age-related macular degeneration who did not receive treatment for their maculopathy. The main outcome measures were visual acuity and intraocular pressure.
  
  
  RESULTS
  In the study group, mean +/- SD visual acuity increased significantly (P =.005 and P =.003, respectively) from 0.17 +/- 0.11 to 0.32 +/- 0.26 and from 0.15 +/- 0.14 to 0.23 +/- 0.19, respectively, after the first and second injections. An increase in visual acuity was found for 10 patients (77%) after the first and second injections. In the control group, visual acuity did not vary significantly during follow-up (P =.81). The difference in change in visual acuity between the study group and control group was significant (P =.01 [Snellen lines] and P =.05 [logMAR units]). The peak in visual acuity and, in a chronologically parallel manner, the peak in intraocular pressure elevation occurred 2 to 5 months after each injection.
  
  
  CONCLUSIONS
  Repeated intravitreal injection of 25 mg of triamcinolone acetonide may lead to an increase in visual acuity in patients with exudative age-related macular degeneration, with the peak in visual acuity and intraocular pressure elevation occurring about 2 to 5 months after each injection.
authors.affiliation: Department of Ophthalmology, Faculty of Clinical Medicine of Mannheim, University of Heidelberg, Heidelberg, Germany. Jost.Jonas@ma.augen.uni-heidelberg.de
authors.forename: Jost B
authors.initials: JB
authors.lastname: Jonas
authors.forename: Imren
authors.initials: I
authors.lastname: Akkoyun
authors.forename: Wido M
authors.initials: WM
authors.lastname: Budde
authors.forename: Ingrid
authors.initials: I
authors.lastname: Kreissig
authors.forename: Robert F
authors.initials: RF
authors.lastname: Degenring
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000188:drug therapy / Q000209:etiology; D005122:Exudates and Transudates; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D007429:Intraocular Pressure / Q000187:drug effects; D008268:Macular Degeneration / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014792:Visual Acuity / Q000187:drug effects; D014822:Vitreous Body
chemical_list: D005938:Glucocorticoids; D014222:Triamcinolone Acetonide