[Effect of intravitreal and orbital floor triamcinolone acetonide injection on intraocular inflammation in patients with active non-infectious uveitis]

Abstract

Background: Currently, triamcinolone acetonide (TA) is frequently used to treat inflammation in non-infectious uveitis. The aim of this study was to compare the effect of TA on intraocular inflammation after a single intravitreal or orbital floor injection of the drug in patients with non-infectious uveitis.

Patients and methods: This was a monocentre, retrospective study in 114 eyes (103 patients). Twenty eyes were treated with intravitreal and 94 eyes with orbital floor TA. The main outcome measure was cells in the anterior chamber and anterior vitreous. Secondary outcome measures included protein accumulation in the aqueous humor (according to laser-flare photometry), best-corrected visual acuity, and complications. Follow-up evaluations were performed at 1, 3, and 6 months after TA injection.

Results: After either intravitreal or orbital floor TA injection, the intraocular inflammation in the anterior chamber and vitreous decreased (p < 0.001, for both administration forms, and at all follow-up time points). Laser-flare values decreased in both groups. One month after injection, the visual acuity in the intravitreally treated patients was increased (p < 0.01), whereas the poor visual acuity persisted in the orbital floor group. The effect on macular oedema after intravitreal TA was better than in the orbital floor group (p < 0.01). Progression and increased cataract incidence were detected in 50 % after intravitreal and in 29 % after orbital floor TA.

Conclusions: After both intravitreal and orbital floor TA injection, the intraocular inflammation decreased. The effect of intravitreal TA on macular oedema and visual acuity was better than that of orbital floor TA, but intraocular pressure elevation and progressive cataract were more often observed in this group.