Prospective optical coherence tomographic evaluation of the efficacy of oral and posterior subtenon corticosteroids in patients with intermediate uveitis.
OBJECTIVE
To prospectively evaluate the efficacy of oral corticosteroids and posterior subtenon injection in the treatment of macular edema in patients with intermediate uveitis using optical coherence tomography (OCT).


METHODS
Twenty-two patients with intermediate uveitis were treated with posterior subtenon injection when the disease was unilateral (group A, n=11) or with oral steroids when the disease was bilateral (group B, n=11). Changes in macular thickness from baseline was determined using OCT in both groups at day 0, day 3, day 14, 6 weeks and 12 weeks.


RESULTS
Statistically significant improvement in Snellen visual acuity in group A was seen at 6 weeks and in group B at 2 weeks. In patients receiving oral corticosteroids, foveal thickness decreased by 63% by day 3. In those treated with posterior subtenon injection, even at day 14 only a 55% reduction of foveal thickness was evident. Spearman's correlation coefficient for visual acuity and foveal thickness was found to be significant.


CONCLUSIONS
OCT confirms a significantly more rapid decrease in macular edema in patients treated with oral corticosteroids. A short course of oral steroids may be useful in enabling earlier visual recovery in patients treated with posterior subtenon injection for unilateral uveitic macular edema.
Venkatesh
Pradeep
P
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. venkyprao@yahoo.com
Abhas
Zaheer
Z
Garg
Satpal
S
Vohra
Rajpal
R
D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D001623:Betamethasone / Q000008:administration & dosage*; D003238:Connective Tissue; D004333:Drug Administration Routes; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D011239:Prednisolone / Q000008:administration & dosage*; D011446:Prospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D015867:Uveitis, Intermediate / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D014792:Visual Acuity / Q000187:drug effects
D005938:Glucocorticoids; D001623:Betamethasone; D011239:Prednisolone; D014222:Triamcinolone Acetonide