title: Suprachoroidal drug infusion for the treatment of severe subfoveal hard exudates.
abstract: OBJECTIVE
  To evaluate the safety, feasibility, and preliminary efficacy of suprachoroidal drug delivery with a microcatheter for the treatment of severe subfoveal hard exudates (SHE) in retinal vasculopathies. Definitive treatments for SHE have not yet been identified and prognosis is unfavorable.
  
  
  METHODS
  In this prospective, interventional pilot study, six eyes of six patients with central or branch retinal vein occlusion or diffuse diabetic macular edema accompanied by massive refractory SHE underwent a single treatment with bevacizumab and triamcinolone administered to the submacular suprachoroidal space via a microcatheter introduced at the pars plana and advanced posteriorly. The main outcome measures included best-corrected visual acuity, vascular leakage, macular thickness, extent of SHE, and complications.
  
  
  RESULTS
  Mean follow-up was 12 months. Three eyes had central retinal vein occlusion, one had branch retinal vein occlusion, and two had chronic diabetic macular edema. Best-corrected visual acuity improved by ≥2 lines in 4 eyes and remained stable in 2 eyes. At 1 month to 2 months postprocedure, SHE was almost completely resolved in all eyes and macular edema was significantly reduced. There were no surgical or postoperative complications.
  
  
  CONCLUSIONS
  Suprachoroidal infusion of drugs can be effective in reabsorbing massive SHE.
authors.affiliation: Ophthalmic Surgery Hospital, University of Pisa, Pisa, Italy. stanos@tin.it
authors.forename: Stanislao
authors.initials: S
authors.lastname: Rizzo
authors.forename: Federica Genovesi
authors.initials: FG
authors.lastname: Ebert
authors.forename: Emanuele Di
authors.initials: ED
authors.lastname: Bartolo
authors.forename: Francesco
authors.initials: F
authors.lastname: Barca
authors.forename: Federica
authors.initials: F
authors.lastname: Cresti
authors.forename: Constanze
authors.initials: C
authors.lastname: Augustin
authors.forename: Albert
authors.initials: A
authors.lastname: Augustin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000068258:Bevacizumab; D002404:Catheterization / Q000379:methods; D003930:Diabetic Retinopathy / Q000188:drug therapy*; D005122:Exudates and Transudates; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008269:Macular Edema / Q000188:drug therapy*; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012170:Retinal Vein Occlusion / Q000188:drug therapy*; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D014222:Triamcinolone Acetonide