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Exudative macular degeneration and intravitreal triamcinolone: 18 month follow up.

Abstract

PURPOSE

To evaluate the safety and efficacy of intravitreal triamcinolone after 18 months of follow up in patients with age-related macular degeneration and subfoveal or juxtafoveal choroidal neovascularization considered unsuitable for laser photocoagulation.

METHODS

Thirty eyes of 28 patients, referred from general eye clinics as well as the private clinic of one of the authors to a hospital-based retinal out-patient clinic, were treated with an intravitreal injection of triamcinolone (4 mg). The primary outcome measure was the proportion of eyes with loss of six or more lines on a Bailey-Lovie Chart. The incidence of adverse events associated with treatment was also observed.

RESULTS

Of the 20 eyes with initial visual acuity (VA) of 6/60 or better, the vision was maintained (+/-1 Bailey-Lovie lines) in 11 eyes (55%), while six eyes (30%) suffered severe visual loss (six or more lines). The VA improved by five to six lines in three of 10 eyes with initial vision of 3/60 or worse. Three of four eyes receiving a second injection suffered either progressive cataract or elevated intra-ocular pressure (IOP) requiring cataract surgery and/or filtering surgery. One of 26 eyes (3%) receiving a single injection showed progression of cataract and elevation of IOP within 6 weeks of treatment and required anti-glaucoma medication for 6 weeks. Progression of nuclear sclerosis 8-12 months after treatment was observed in six of 26 eyes (23%) receiving a single injection.

CONCLUSIONS

The results of the present study suggest that a single intravitreal injection of 4 mg triamcinolone is reasonably well tolerated by the human eye. The rate of development of severe visual loss was less than reported for historical controls. Because the results are preliminary and uncontrolled, the treatment should not be used routinely until its benefit to patients is established by a prospective, randomized controlled study.

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  • Authors+Show Affiliations

    ,

    Save Sight and Eye Health Institute, Department of Clinical Ophthalmology, University of Sydney, New South Wales, Australia.

    , , , ,

    Source

    MeSH

    Aged
    Aged, 80 and over
    Choroidal Neovascularization
    Exudates and Transudates
    Female
    Follow-Up Studies
    Glucocorticoids
    Humans
    Injections
    Intraocular Pressure
    Macular Degeneration
    Male
    Safety
    Treatment Outcome
    Triamcinolone Acetonide
    Visual Acuity
    Vitreous Body

    Pub Type(s)

    Clinical Trial
    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    9843254

    Citation

    Challa, J K., et al. "Exudative Macular Degeneration and Intravitreal Triamcinolone: 18 Month Follow Up." Australian and New Zealand Journal of Ophthalmology, vol. 26, no. 4, 1998, pp. 277-81.
    Challa JK, Gillies MC, Penfold PL, et al. Exudative macular degeneration and intravitreal triamcinolone: 18 month follow up. Aust N Z J Ophthalmol. 1998;26(4):277-81.
    Challa, J. K., Gillies, M. C., Penfold, P. L., Gyory, J. F., Hunyor, A. B., & Billson, F. A. (1998). Exudative macular degeneration and intravitreal triamcinolone: 18 month follow up. Australian and New Zealand Journal of Ophthalmology, 26(4), pp. 277-81.
    Challa JK, et al. Exudative Macular Degeneration and Intravitreal Triamcinolone: 18 Month Follow Up. Aust N Z J Ophthalmol. 1998;26(4):277-81. PubMed PMID: 9843254.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Exudative macular degeneration and intravitreal triamcinolone: 18 month follow up. AU - Challa,J K, AU - Gillies,M C, AU - Penfold,P L, AU - Gyory,J F, AU - Hunyor,A B, AU - Billson,F A, PY - 1998/12/8/pubmed PY - 1998/12/8/medline PY - 1998/12/8/entrez SP - 277 EP - 81 JF - Australian and New Zealand journal of ophthalmology JO - Aust N Z J Ophthalmol VL - 26 IS - 4 N2 - PURPOSE: To evaluate the safety and efficacy of intravitreal triamcinolone after 18 months of follow up in patients with age-related macular degeneration and subfoveal or juxtafoveal choroidal neovascularization considered unsuitable for laser photocoagulation. METHODS: Thirty eyes of 28 patients, referred from general eye clinics as well as the private clinic of one of the authors to a hospital-based retinal out-patient clinic, were treated with an intravitreal injection of triamcinolone (4 mg). The primary outcome measure was the proportion of eyes with loss of six or more lines on a Bailey-Lovie Chart. The incidence of adverse events associated with treatment was also observed. RESULTS: Of the 20 eyes with initial visual acuity (VA) of 6/60 or better, the vision was maintained (+/-1 Bailey-Lovie lines) in 11 eyes (55%), while six eyes (30%) suffered severe visual loss (six or more lines). The VA improved by five to six lines in three of 10 eyes with initial vision of 3/60 or worse. Three of four eyes receiving a second injection suffered either progressive cataract or elevated intra-ocular pressure (IOP) requiring cataract surgery and/or filtering surgery. One of 26 eyes (3%) receiving a single injection showed progression of cataract and elevation of IOP within 6 weeks of treatment and required anti-glaucoma medication for 6 weeks. Progression of nuclear sclerosis 8-12 months after treatment was observed in six of 26 eyes (23%) receiving a single injection. CONCLUSIONS: The results of the present study suggest that a single intravitreal injection of 4 mg triamcinolone is reasonably well tolerated by the human eye. The rate of development of severe visual loss was less than reported for historical controls. Because the results are preliminary and uncontrolled, the treatment should not be used routinely until its benefit to patients is established by a prospective, randomized controlled study. SN - 0814-9763 UR - https://www.unboundmedicine.com/medline/citation/9843254/Exudative_macular_degeneration_and_intravitreal_triamcinolone:_18_month_follow_up_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0814-9763&date=1998&volume=26&issue=4&spage=277 DB - PRIME DP - Unbound Medicine ER -