title: Intravitreal triamcinolone for the treatment of refractory macular edema in idiopathic intermediate or posterior uveitis.
abstract: OBJECTIVE
  Cystoid macular edema (CME) is the most significant cause of visual loss associated with idiopathic uveitis. The authors report on the use of intravitreal triamcinolone acetonide (IVTA) in a group of patients with macular edema due to idiopathic intermediate and posterior uveitis.
  
  
  METHODS
  Retrospective, noncomparative, interventional case series. Thirty-three eyes were included with uveitic CME that was refractory to topical steroids, oral prednisone, or a combination thereof. Previous steroid treatment did not result in elevated intraocular pressure (IOP). The eyes received an intravitreal injection with 10 mg triamcinolone acetonide, after best-corrected visual acuity (BCVA) and fluorescein angiography (FA) were assessed. Ophthalmologic examination including FA was regularly performed during a 1-year follow-up period.
  
  
  RESULTS
  Within 12 weeks after injection of IVTA, 50% of the eyes responded with an improvement in vision of more than two lines and 30% of the eyes reached an IOP of > or = 21 mmHg (p<0.01). All eyes with an elevated IOP responded well on topical antiglaucoma medication. After 12 months follow-up 40% of the eyes responded with an improvement in vision of more than two lines and 28% of the affected eyes underwent phacoemulsification during the follow-up. No other complications occurred within a year after the treatment.
  
  
  CONCLUSIONS
  In macular edema due to idiopathic intermediate or posterior uveitis IVTA improves the visual acuity within the first 3 months. However, thereafter the visual acuity decreases again. Cataract and elevated IOP are common side effects.
authors.affiliation: UMC St Radboud, Department of Ophthalmology, Nijmegen - The Netherlands. b.hogewind@ohk.umcn.nl
authors.forename: B F T
authors.initials: BF
authors.lastname: Hogewind
authors.forename: C
authors.initials: C
authors.lastname: Zijlstra
authors.forename: B J
authors.initials: BJ
authors.lastname: Klevering
authors.forename: C B
authors.initials: CB
authors.lastname: Hoyng
mesh_terms: D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007267:Injections; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015867:Uveitis, Intermediate / Q000150:complications / Q000188:drug therapy*; D015866:Uveitis, Posterior / Q000150:complications / Q000188:drug therapy*; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body
chemical_list: D005938:Glucocorticoids; D014222:Triamcinolone Acetonide