High-Dose Decanted Triamcinolone for Treatment-Resistant Persistent Macular Edema

Area of Science:

• Ophthalmology
• Retinal diseases
• Pharmacological treatments

Background:

• Persistent macular edema (ME) poses a significant challenge in ophthalmology, often proving resistant to standard treatments.
• High-dose intravitreal triamcinolone acetonide (HD-IVTA) is explored as a therapeutic option for refractory ME.

Purpose of the Study:

• To evaluate the efficacy and outcomes of decanted HD-IVTA injections in patients with treatment-resistant persistent ME.
• To assess visual acuity and central macular thickness (CMT) changes following HD-IVTA treatment.

Main Methods:

• Seventy-seven eyes of 70 patients with persistent ME, unresponsive to prior treatments, received as-needed HD-IVTA injections.
• Best-corrected visual acuity and CMT were monitored throughout the follow-up period.

Main Results:

• A significant improvement in visual acuity (mean ETDRS letter score increase of 6.3 at 3 months, 4.8 at 12 months) and a reduction in CMT were observed.
• 63.6% of eyes required only one HD-IVTA injection, with a mean duration of effect of 6 months.
• Elevated intraocular pressure occurred in 40.2% of eyes, and cataract formation was noted in 21.4% of phakic eyes.

Conclusions:

• Decanted HD-IVTA injections offer a viable treatment for persistent macular edema resistant to other therapies.
• A single HD-IVTA injection can provide sustained efficacy for up to six months, improving visual outcomes.