gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

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Pars-plana vitrectomy, ILM peeling and intravitreal Triamcinolon for the treatment of uveitic cystoid macular edema

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  • corresponding author M. Gutfleisch - Department of Ophthalmology at St. Franziskus Hospital, Münster
  • G. Spital - Department of Ophthalmology at St. Franziskus Hospital, Münster
  • A. Mingels - Department of Ophthalmology at St. Franziskus Hospital, Münster
  • D. Pauleikhoff - Department of Ophthalmology at St. Franziskus Hospital, Münster
  • A. Lommatzsch - Department of Ophthalmology at St. Franziskus Hospital, Münster
  • A. Heiligenhaus - Department of Ophthalmology at St. Franziskus Hospital, Münster

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogSO.05.05

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dog2004/04dog456.shtml

Published: September 22, 2004

© 2004 Gutfleisch et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

Cystoid macular edema (CME) is a frequent cause of vision loss in patients with uveitis. When medical therapy fails, intravitreal triamcinolone and/or vitrectomy have been suggested. This study investigated the effects of pars-plana vitrectomy (PPV) with peeling of the internal limiting membrane (ILM) and with intraoperative triamcinolone on the CME.

Methods

Uveitis patients with CME (n=19) that did not improve with systemic corticosteroids and/or immunosuppression and carbonanhydrase-inhibitors, were included in this study. Patients had anterior uveitis (n=4), intermediate uveitis (n=9), posterior uveitis (n=3), panuveitis (n=3), sarcoidosis (n=4), multiple sclerosis (n=2) or mixed connective tissue disease (n=1). Visual acuity tests, tonometry, fluorescent angiographical appearance and postoperative complications were analyzed. Mean follow-up was 8.6 months.

Results

By means of ophthalmoscopy and fluorescent angiography, CME was improved in 50% of the patients after 2 weeks. After 6 months, CME was improved in 40%, but worsened in further 27% as compared to the preoperative level. Visual improvement was detected in 35% after 6 weeks, and in 30% after 6 months. Cataract progressed after surgery in 83.3% of the phacic patients. Increased IOP was detected in 27% at 2 weeks and in 21% at 6 months after surgery.

Conclusions

Uveitic CME that did not respond to medical treatment may improve in selected patients after PPV with intravitreal triamcinolone. The effect appears to be transient. Frequent complications were cataract formation and ocular hypertension.