Intravitreal and subtenon depot triamcinolone as treatment of retinitis pigmentosa associated cystoid macular edema.
We present a case of retinitis pigmentosa (RP) related cystoid macular edema (CME) refractory to oral acetazolamide and topical ketorolac that was treated with intravitreal and subtenon depot triamcinolone. A 32-year-old male with RP presented with complaints of bilateral decrease in visual acuity. His best-corrected visual acuity (BCVA) was 20/50 in the right eye and 20/100 in the left eye. After being informed of the available treatment options, the patient received bilateral intravitreal injection triamcinolone. The patient's BCVA improved to 20/40 in the right eye and 20/50 in the left eye and the CME was resorbed. However, 5 months after the injection in the left eye and two months in the right eye, visual acuity decreased due to recurrence of CME. We performed a second intravitreal injection in the left eye with improvement of visual and anatomic results, but we observed a recurrence of CME. Afterwards, we treated the patient with subtenon depot triamcinolone in both eyes, with the result that there was no recurrence after 4 months in OD or after 3 months in OS. We conclude that intravitreal and subtenon depot triamcinolone appear to provide at least temporary benefit in refractory CME as regards the improvement of visual acuity.
Department of Ophthalmology, Vila Nova Gaia/Espinho Hospital, Rua Conceição Fernandes, 4434-502 Vila Nova Gaia, Portugal.
Sidnei
S
Barge
Department of Ophthalmology, Vila Nova Gaia/Espinho Hospital, Rua Conceição Fernandes, 4434-502 Vila Nova Gaia, Portugal.
Renata
R
Rothwell
Department of Ophthalmology, Vila Nova Gaia/Espinho Hospital, Rua Conceição Fernandes, 4434-502 Vila Nova Gaia, Portugal.
Paula
P
Sepúlveda
Department of Ophthalmology, Vila Nova Gaia/Espinho Hospital, Rua Conceição Fernandes, 4434-502 Vila Nova Gaia, Portugal.
Luís
L
Agrelos