title: [Safety and efficacy of subconjunctival triamcinolone injections in the management of uveitic macular edema: retrospective study of thirty-one cases].
abstract: Triamcinolone acetonide (Kenacort) is a corticosteroid that can be administrated by subconjunctival injection, with an extended release for up to three months. Our retrospective study aims to analyze safety and efficacy of subconjunctival triamcinolone injections in the treatment of uveitic macular edema. We included 31 eyes of 30 patients, who had one or several injections. We studied the progression of visual acuity, central macular thickness by optical coherence tomography (OCT), intraocular pressure, and presence or absence of cataract, on the day of injection (T0), and at 1, 3, 6 and 12 months after injection. Twenty-one patients had only one injection; 10 patients had 2. The 12-month follow-up showed an improvement in visual acuity with an initial mean of 0.36 ± 0.27 logMAR to 0.23 ± 0.33 logMAR at 3 months of follow-up (P<0.0004), and to 0.24 ± 0.21 logMAR at 12 months (P=0.0371), for a two-line improvement. A decrease in mean central macular thickness was measured by OCT, from a mean of 444 ± 112 μm (0.24 ± 0.11 logSD-OCT) at T0 to 355 ± 103 μm (0.14 $ ± 0.10 logSD-OCT) at 3 months (P=0.0002). We did not find a significant increase in intraocular pressure, and we diagnosed one cataract during follow-up but this occurred in the uninjected eye as well. Subconjunctival injection of triamcinolone acetonide is a safe and effective treatment of macular edema related to uveitis. Initial clinical monitoring is necessary to detect iatrogenic events.
authors.affiliation: Service d'ophtalmologie, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France. Electronic address: alice.bleriot@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Bleriot
authors.affiliation: Service d'ophtalmologie, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France.
authors.forename: C
authors.initials: C
authors.lastname: Couret
authors.affiliation: Service d'ophtalmologie, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France.
authors.forename: G
authors.initials: G
authors.lastname: Le Meur
authors.affiliation: Service d'ophtalmologie, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France.
authors.forename: P
authors.initials: P
authors.lastname: Lebranchu
authors.affiliation: Service d'ophtalmologie, CHU de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France.
authors.forename: M
authors.initials: M
authors.lastname: Weber
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D002386:Cataract / Q000150:complications; D003228:Conjunctiva; D004341:Drug Evaluation; D019773:Epiretinal Membrane / Q000150:complications; D005260:Female; D006801:Humans; D056965:Injections, Intraocular; D007429:Intraocular Pressure / Q000187:drug effects; D008266:Macula Lutea / Q000648:ultrastructure; D008269:Macular Edema / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D014605:Uveitis / Q000150:complications* / Q000188:drug therapy; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D000893:Anti-Inflammatory Agents; D014222:Triamcinolone Acetonide
keywords: Corticothérapie péri-oculaire; Injection sous-conjonctivale; Periocular corticosteroid therapy; Subconjunctival injection; Uveitic macular edema; Uveitis; Uvéite; Œdème maculaire inflammatoire