Six patients with chronic CME resistant to treatment with systemic steroids, orbital floor steroids, and cyclosporine A. Three patients were followed for more than 1 year, and the other three for between 3 and 9 months.
Intervention
Injection of 2 mg of TA into the vitreous cavity.
Testing
Optical coherence tomography scanning of the fovea before and after injection and logarithmic minimal angle of resolution visual acuity.
Main outcome measures
Visual acuity, retinal thickness, cystoid space height, and intraocular pressure.
Results
There was complete anatomic resolution of CME in five of the six cases within 1 week after injection. Cystoid spaces began to return between 6 weeks and 3 months after injection. Two patients with longer term follow-up responded to further orbital floor steroid injection and had no CME 1 year later. One patient had raised intraocular pressure develop, requiring a trabeculectomy. Mean improvement in visual acuity after 12 months was 0.27 (range, 0.14–0.42).
Conclusions
Complete anatomic and, to some extent, functional recovery can be induced by intravitreal TA despite long-term refractory inflammatory CME. Optical coherence tomography aids in the management of these cases.
Manuscript no. 200172.
aGKT Department of Ophthalmology, Rayne Institute, St Thomas’ Hospital, London, England, UK
bDepartment of Ophthalmology, St Thomas’ Hospital, London, England, UK
Reprint requests to Richard J. Antcliff, FRCOphth, GKT Department of Ophthalmology, Rayne Institute, St Thomas’ Hospital, Lambeth Palace Road, London SE1 7EH. England
☆ Supported by the Allerton Fund, London, England, and the Iris Fund for the Prevention of Blindness, London, England.
ABSTRACT