gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Epiretinal deposit of Triamcinolone Acetonide (TA) in the area of the posterior pole after intravitreal TA injection with and without previous vitrectomy

Meeting Abstract

  • corresponding author G.B. Jaissle - Eberhard-Karls-Universität Tübingen, Universitäts-Augenklinik, Abt. I, Tübingen
  • P. Szurman - Eberhard-Karls-Universität Tübingen, Universitäts-Augenklinik, Abt. I, Tübingen
  • M. Völker - Eberhard-Karls-Universität Tübingen, Universitäts-Augenklinik, Abt. I, Tübingen
  • K.U. Bartz-Schmidt - Eberhard-Karls-Universität Tübingen, Universitäts-Augenklinik, Abt. I, Tübingen

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogFR.04.11

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dog2004/04dog198.shtml

Published: September 22, 2004

© 2004 Jaissle et al.
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Outline

Text

Objective

Intravitreal injection of crystalline Triamcinolone Acetonide (TA) suspension has gained a brought spectrum of indications in the last years because of the prolonged intraocular cortiocosteroid effect. We report 2 on cases of epiretinal TA deposit at the posterior pole in a vitrectomized and a not vitrectomized eye following intravitreal TA injection.

Methods

A 48-years-old patient (1) underwent cataract surgery because of a complicated cataract after a pars plana vitrectomy with epiretinal peeling of a macular pucker. Due to persistence of a postoperative ME surgery was combined with an intravitreal injection of 25mg TA. In another not vitrectomized patient (2) intravitreal injection of 25mg TA was performed because of a cystoid ME after retinal vein stasis retinopathy. The vehicle had been removed prior to the injection. Both patients were investigated over a time period of several months.

Results

Patient 1 disclosed pronounced white epiretinal TA deposits at the posterior pole one day after injection. These were rarely visible after 2 days and disappeared completely after 6 weeks. The visual acuity reached a stable level of 0.63 after 8 months compared to 0.2 preoperatively. Both, funduscopy and angiography showed normal morphology of the posterior pole without suspicion of ME and a normal optic nerve head. OCT revealed a reduction of the central retinal thickness to 335 µm. There were striking diffuse visual field defects which did not correlate with the localisation of the TA deposits, however. Most probably they appeared to be connected with the previously performed vitreoretinal surgery. In patient 2, besides the TA crystals in the vitreous body, there were also epiretinal TA deposits at the posterior pole which showed a distinct reduction within 2 weeks.

Conclusions

After intravitreal injection of TA the crystals can deposit in the area of the posterior pole due to gravity according to the posture of the head. Particularly, vitrectomized eyes predispose for such sedimentation. However, also in not vitrectomized eyes epiretinal deposits can occur. There were no morphological and functional signs of TA induced retinal toxicity, even after pronounced TA deposits.