A manually made needle for treating Pseudophakic cystoid macular edema by injecting triamcinolone acetonide in the suprachoroidal space: A case report

Abstract

Purpose: This case was conducted to report the effectiveness and security of a manually made needle to inject triamcinolone acetonide in the suprachoroidal space (SCS) in a 52-year-old female with pseudophakic cystoid macular edema (PCME) in the challenging socio-economical situations in Syria.

Methods: This case report is an interventional case of a 52-year-old female presented with a four-week history of reduced vision secondary to Pseudophakic cystoid macular edema (PCME). The patient attended Marashi Eye Clinic Center for a clinical examination and followed up with Optical Coherence Tomography (OCT) at baseline. The patient was treated by one injection of triamcinolone acetonide and followed up within one week, 4 weeks, 8 weeks, 16 weeks, and 24 weeks in the suprachoroidal space (SCS) using a manually made needle with assessing the efficacy and potential ocular complications.

Results: The best-corrected visual acuity (BCVA) had improved significantly from baseline 20/60 to 20/30 at 24 weeks with a complete anatomical resolution of macular edema at 24 weeks from baseline. No ocular complications were noticed during the study period.

Conclusions and importance: Injecting triamcinolone acetonide in suprachoroidal space (SCS) using a manually made needle plays an essential role in treating Pseudophakic cystoid macular edema (PCME) without compromising security and efficiency.

Keywords: Efficacy; Injection; Pseudophakic cystoid macular edema; Socio-economical; Suprachoroidal; Triamcinolone acetonide.

Fig. 1

Shows a normal cross-section OCT for the patient before phacoemulsification surgery.

Fig. 2

(A) The injecting process. (B) Shows the manually made needle with a rubber stopper.

Fig. 3

OCT scans show (A) Cystic macular edema with subretinal fluid. (B) 24 hours later, after injecting triamcinolone acetonide in the suprachoroidal space, shows a decrease in central macular thickness and resolved intraretinal cysts. (C, D) 8 weeks and 24 weeks OCT scans show a maintained result of therapy through injecting triamcinolone acetonide in the suprachoroidal space.