[Low dose intravitreal triamcinolone acetonide in the treatment of neovasular glaucoma]

To report the effect of an intravitreal injection of 4 mg of crystalline triamcinolone acetonide (Kenacort) as symptomatic treatment of neovascular glaucoma.

This clinical study is based on clinical and experimental investigations that examined the tolerability and the angiostatic effect of triamcinolone acetonide. The study includes prospectively 8 eyes of 8 patients with neovascular glaucoma secondary to ischemic central retinal vein occlusion (n=8). All patients received an intravitreal injection of 4 mg of crystalline triamcinolone acetonide (0.1 cc) as the only procedure or in combination with transscleral cyclodiode as glaucoma treatment. Their mean age was 74.5 +/- 14.4 years. Mean intraocular pressure (IOP) was 38.9 +/- 9.3 mmHg. Mean follow-up was 6 months.

4 of 8 patients were treated by crystalline triamcinolone acetonide as the only procedure (n=3). Twenty seven days after intravitreal kenacort injection, the others four patients have been treated by transscleral cyclodiode (n=4) as glaucoma treatment. After injection, including the first postoperative day, patients report a subjective reduction of ocular pain. Furthermore no intra- or extraocular inflammatory reactions were observed during the follow-up. Intraocular pressure was significantly reduced to 18 +/- 6.2 mm Hg at the end of the follow-up period. When considering only the four patients in which the intraocular cortisone injection was the only procedure performed, mean intraocular pressure decreased from 41.75 +/- 7.05 mm Hg to 20.5 +/- 6.6 mm Hg. Iris neovascularisation was significantly decreased from grade IV to grade I in all patients at the end of the follow-up

Intravitreal injection of 4 mg triamcinolone acetonide contributes to a better management of the neovascular glaucoma.