Intravitreal triamcinolone injection for unresponsive cystoid macular oedema in probable Behçet's disease as an...

We present the description of a successful outcome of intravitreal triamcinolone injection (IVTA) in a patient with cystoid macular oedema (CME) and severe retinal vasculitis suggestive of ocular Behçet's disease.

A healthy 32 year-old Caucasian man presented initially with right retinal vasculitis with preserved vision. Despite initial systemic treatment with high dose steroids, he developed CME with a reduction in vision.

IVTA injection was carried out, and resulted in a good anatomic and functional response. The same picture developed in his left eye 2 months later and a similar response occurred following IVTA. Six months after the initial episode and despite treatment with cyclosporine and azathioprine, CME reoccurred in his RE inducing a decrease of his VA from 6/5 to 6/24. IVTA injection was repeated and a week later his VA increased to 6/6. At this stage patient was referred for initiation of therapy with infliximab.

IVTA injection appears to be very helpful for the resolution of acute CME and for visual recovery, but we would like to emphasise that even though this approach seems to be helpful in an acute situation, the effect is short-lived and proper immunosuppression is needed for long-term control of the disease and its complications.