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. 2013:2013:591681.
doi: 10.1155/2013/591681. Epub 2013 Dec 23.

Intravitreal and subtenon depot triamcinolone as treatment of retinitis pigmentosa associated cystoid macular edema

Sidnei Barge  1 , Renata Rothwell  1 , Paula Sepúlveda  1 , Luís Agrelos  1
Affiliations

Intravitreal and subtenon depot triamcinolone as treatment of retinitis pigmentosa associated cystoid macular edema

Sidnei Barge et al. Case Rep Ophthalmol Med. 2013.

Abstract

We present a case of retinitis pigmentosa (RP) related cystoid macular edema (CME) refractory to oral acetazolamide and topical ketorolac that was treated with intravitreal and subtenon depot triamcinolone. A 32-year-old male with RP presented with complaints of bilateral decrease in visual acuity. His best-corrected visual acuity (BCVA) was 20/50 in the right eye and 20/100 in the left eye. After being informed of the available treatment options, the patient received bilateral intravitreal injection triamcinolone. The patient's BCVA improved to 20/40 in the right eye and 20/50 in the left eye and the CME was resorbed. However, 5 months after the injection in the left eye and two months in the right eye, visual acuity decreased due to recurrence of CME. We performed a second intravitreal injection in the left eye with improvement of visual and anatomic results, but we observed a recurrence of CME. Afterwards, we treated the patient with subtenon depot triamcinolone in both eyes, with the result that there was no recurrence after 4 months in OD or after 3 months in OS. We conclude that intravitreal and subtenon depot triamcinolone appear to provide at least temporary benefit in refractory CME as regards the improvement of visual acuity.

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Figures

Figure 1
Figure 1
Mild subcapsular cataract in the left eye.
Figure 2
Figure 2
Peripheral and equatorial hyperpigmentation, arteriolar attenuation, pallor of the optic nerve, and CME.
Figure 3
Figure 3
Fluorescein angiography—little accumulation of the dye in the late phases.
Figure 4
Figure 4
OCT spectral domain: diffuse retinal thickening with cystic areas of low reflectivity.
Figure 5
Figure 5
Goldmann kinetic perimetry: tubular visual field.
Figure 6
Figure 6
OCT spectral domain OS after 2nd intravitreal injection of triamcinolone.
Figure 7
Figure 7
OCT spectral domain OD after intravitreal injection of triamcinolone.
Figure 8
Figure 8
OCT spectral domain OD after subtenon depot triamcinolone.
Figure 9
Figure 9
OCT spectral domain OS after subtenon depot triamcinolone.
Figure 10
Figure 10
Biomicroscopy of left eye showed aggravation of subcapsular cataract.
See this image and copyright information in PMC

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