Intravitreal triamcinolone acetonide for the management of papillophlebitis and associated macular edema

Abstract

Background: To investigate the efficacy of intravitreal injection of triamcinolone acetonide in the management of papillophlebitis and associated cystoid macular edema.

Methods: This study was a retrospective medical records review of four eyes of four patients (three males and one female) who had approximately 2-4 months history of papillophlebitis and associated persistent cystoid macular edema. These patients were treated with a single intravitreal injection of 4 mg triamcinolone acetonide. Mean follow-up time was 15 +/- 4 months. The outcome measures included best corrected visual acuity (BCVA), intraocular pressure (IOP), and central retinal thickness by optical coherence tomography (OCT).

Results: The BCVA ranged from 20/100 to 20/60 pre-operation. The mean gain in BCVA was 7 +/- 1 Snellen lines. All eyes had BCVA of 20/20 at the last visit. The mean baseline central retinal thickness as measured by OCT was 529 +/- 53 microm. The mean central retinal thickness by OCT was 235 +/- 15 microm at 1-week follow-up examination. At the last visit the mean central retinal thickness by OCT was 161 +/- 7 microm. One patient experienced an increase in IOP after the first injection and another patient had IOP elevation after the second injection. Both were well controlled with single topical anti-glaucoma medication.

Conclusion: Intravitreal injection of triamcinolone acetonide appears to be an effective treatment for patients with papillophlebitis and associated cystoid macular edema.