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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

References

    1. Marmor MF, Aguirre G, Arden G. Retinitis pigmentosa. A symposium on terminology and methods of examination. Ophthalmology. 1983;90(2):126–131. - PubMed
    1. Ozdemir H, Karacorlu M, Karacorlu S. Intravitreal triamcinolone acetonide for treatment of cystoid macular oedema in patients with retinitis pigmentosa. Acta Ophthalmologica Scandinavica. 2005;83(2):248–251. - PubMed
    1. Fishman GA, Glenn AM, Gilbert LD. Rebound of macular edema with continued use of methazolamide in patients with retinitis pigmentosa. Archives of Ophthalmology. 1993;111(12):1640–1646. - PubMed
    1. Fishman GA, Maggiano JM, Fishman M. Foveal lesions seen in retinitis pigmentosa. Archives of Ophthalmology. 1977;95(11):1993–1996. - PubMed
    1. Moldow B, Sander B, Larsen M, et al. The effect of acetazolamide on passive and active transport of fluorescein across the blood-retina barrier in retinitis pigmentosa complicated by macular oedema. Graefe’s Archive for Clinical and Experimental Ophthalmology. 1998;236(12):881–889. - PubMed

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