title: [Intramuscular depot steroids : Possible treatment of postsurgical cystoid macula edema with steroid response?]
abstract: We report on a patient with postsurgical cystoid macular edema (CME) after phacoemulsification and multifocal intraocular lens (MIOL) implantation. At first, there was a very good reaction to intravitreal triamcinolone, inducing complete regression of the edema without increasing intraocular pressure (IOP). One year later the patient suffered from retinal detachment and was treated with vitrectomy, laser, and gas tamponade. Afterward, he developed macular pucker with edema. After surgical treatment with pucker peeling and intravitreal triamcinolone, the patient showed a steroid response and an increase IOP. Postoperatively, there was a recurrence of CME. A coincidental administration of a steroid injection intramuscularly by the general practitioner achieved a prompt reduction of the CME without increasing IOP. This case shows that an initially good reaction to triamcinolone without increasing IOP does not rule out a future steroid response, and that a potential treatment option for CME in patients with a known steroid response could consist of intramuscularly injected steroids.
authors.affiliation: Knappschaftsaugenklinik Sulzbach, An der Klinik 10, 66280, Sulzbach, Deutschland. anna.seuthe@googlemail.com.
authors.forename: A-M
authors.initials: AM
authors.lastname: Seuthe
authors.affiliation: Knappschaftsaugenklinik Sulzbach, An der Klinik 10, 66280, Sulzbach, Deutschland.|Universitätsaugenklinik Tübingen, Tübingen, Deutschland.
authors.forename: P
authors.initials: P
authors.lastname: Szurman
authors.affiliation: Knappschaftsaugenklinik Sulzbach, An der Klinik 10, 66280, Sulzbach, Deutschland.
authors.forename: K T
authors.initials: KT
authors.lastname: Boden
mesh_terms: D001623:Betamethasone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D003692:Delayed-Action Preparations; D006801:Humans; D007273:Injections, Intramuscular; D007910:Lenses, Intraocular; D008269:Macular Edema / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D012008:Recurrence; D012086:Reoperation; D012163:Retinal Detachment / Q000000981:diagnostic imaging / Q000601:surgery; D041623:Tomography, Optical Coherence; D014221:Triamcinolone / Q000008:administration & dosage / Q000009:adverse effects; D014821:Vitrectomy
chemical_list: D003692:Delayed-Action Preparations; D014221:Triamcinolone; C011175:betamethasone-17,21-dipropionate; D001623:Betamethasone
keywords: Intramuscular steroid application; Intraocular pressure increase; Postoperative cystoid macular edema; Steroid response; Triamcinolone