Early effects of intravitreal triamcinolone on macular edema: mechanistic implication.
OBJECTIVE
To evaluate the early effects of intravitreal triamcinolone acetonide (TA) on cystoid macular edema associated with retinal vein occlusion and diabetic retinopathy.


METHODS
Prospective, interventional, small case series.


METHODS
Four patients with cystoid macular edema resulting from retinal vein occlusion or diabetic retinopathy of more than 4 months' duration and evaluated as suitable for treatment with intravitreous injection of TA.


METHODS
After ophthalmic examination, including visual acuity assessment, intraocular pressure (IOP) measurement, and optical coherence tomography (OCT) analysis, the patients received a single intravitreal injection of 4 mg TA. After the injection, consecutive visual acuity assessment, IOP measurement, and OCT analysis were performed after 1 hour, 6 hours, 1 week, and 2 weeks.


METHODS
Optical coherence tomography assessment of macular thickness.


RESULTS
Macular thickness and edema initially were reduced as early as 1 hour after TA injection. A further continuous decrease was observed during the 2 weeks after treatment.


CONCLUSIONS
This rapid effect of intravitreal TA is interpreted to indicate that nongenomic effects on retinal or retinal pigment epithelial cell membranes, or both, may be responsible for this phenomenon. Identifications of these mechanisms may help design alternative, more specific drugs for the treatment of macular edema.
Miyamoto
Noriko
N
INSERM U598 and University René Descartes, Paris, France.
Iossifov
Detelin
D
Metge
Florence
F
Behar-Cohen
Francine
F
D000368:Aged; D000369:Aged, 80 and over; D003930:Diabetic Retinopathy / Q000150:complications*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007267:Injections; D008266:Macula Lutea / Q000187:drug effects; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012170:Retinal Vein Occlusion / Q000150:complications*; D013997:Time Factors; D041623:Tomography, Optical Coherence; D014221:Triamcinolone / Q000008:administration & dosage* / Q000627:therapeutic use; D014822:Vitreous Body
D005938:Glucocorticoids; D014221:Triamcinolone