[Treatment of Graves macular edema with intravitreal injection of corticosteroids]

To determine if intravitreal injection of triamcinolone is an effective option in treating severe macular oedema unresponsive to other treatments.

Fifteen eyes with severe macular oedema of long duration (9-30 months) were offered intravitreal injection of 4 mg triamcinolone. The visual acuity and anatomic responses were monitored with pre- and postoperative fluorescein angiography and optical coherence tomography (OCT).

The minimal follow-up was 3 months (mean = 6 months). The central macular thickness evaluated by OCT decreased by 50%. This beneficial effect was correlated with a significant improvement in visual acuity. Ten of 15 patients (66%) improved their visual acuity by more than two Snellen lines. We could observe a significant increase in intraocular pressure (mean = 15%) due to corticosteroid medication. No injection-related complication occurred. One patient had to be retreated after 3 months due to recurrence of macular oedema.

Intravitreal triamcinolone is a promising therapeutic option for severe macular oedema. Further study is warranted to evaluate the long-term efficacy and safety, as well as the need for retreatment.