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.

Purpose: To study the efficacy of the antiinflammatory agent triamcinolone (Kenacort A-40) in patients with exudative age-related macular degeneration and subfoveal and juxtafoveal choroidal new vessels, considered unsuitable for laser photocoagulation.Method: Thirty eyes of 28 patients were treated with intravitreal injection of triarncinolone. The subsequent visual acuity (VA) of treated eyes was compared with published VA outcomes of untreated eyes. Patients were classified into three types according to their responses to treatment.Results: Within two weeks of receiving treatment, exudation decreased and vision improved in the majority of Types I and II patients (870/0), the trend continuing in longer term follow-up. The overall VA outcome for treated eyes was significantly better than published VA data for untreated exudative macular lesions. Conclusions:The preliminary results are encouraging and no serious side effects of a single injection of triamcinolone have been detected in patients followed for up to 18 months. The treatment should, however, continue to be regarded as unproven and only administered in the context of a prospective, case-controlled clinical trial.

Aim: To determine the efficacy and safety of perfluorocarbon liquid as a short term postoperative tamponade in patients with retinal detachment from giant retinal tears. Method: A retrospective consecutive case series of patients with retinal detachment from giant retinal tears who underwent vitrectomy using perfluorocarbon liquid as a short term postoperative internal tamponade. The perfluorocarbon liquid was removed 5-14 days (mean 7.5 days) later and replaced by gas or silicone oil. Scleral buckling was performed in some cases with proliferative vitreoretinopathy. The crystalline lens was removed if there was interference with the surgical view or if it was subluxated. The success rate of retinal reattachment, visual outcome, and postoperative complications were assessed. Results: A total of 62 eyes of 61 patients with a follow up of 8-69 months (mean 24.5 months) were included. All retinas were attached intraoperatively. 14 eyes (22.6%) developed re-detachment and additional operations were performed in 13 eyes. At final visit, 58 eyes (93.5%) had retinas that remained attached with visual acuity 6/12 or better in 27 eyes (46.5%). The visual acuity improved in 34 eyes (54.8%) with 28 eyes (45.2%) improving at least two Snellen lines, it was unchanged in 20 eyes (32.3%), and was worse in eight eyes (12.9%). Three patients developed glaucoma that was controlled medically. There was no retained perfluorocarbon liquid in any eyes. Conclusion: Perfluorocarbon liquid appears safe and effective to use as a short term postoperative tamponade in management of retinal detachment from giant retinal tears.

We examined the records of 53 patients treated for choroidal melanoma between 1985 and 1989. The aim of this study was to assess the safety and short-term results of iodine-125 episcleral plaque therapy. There were 28 males and 25 females, aged 20 to 77 years (median 61 years), treated for single tumours with a median diameter of 9 mm (range 5 to 15 mm) and with a median thickness of 4 mm (range 2 to 10 mm). The plaques containing iodine-125 seeds were chosen according to tumour size: 10 mm (16 patients); 15 mm (36 patients); 20 mm (one patient). All patients are alive at last follow-up (median 1.3 years, range 4 months to 3.3 years). Four patients underwent enucleation for melanoma progression. Thirty patients have developed some type of complication (more than one complication occurred in the same eye in 12 patients): retinitis (19), optic neuropathy (7); cataract (4), rubeosis iridis (2). Overall, visual acuity deteriorated in 32 patients, remained stable in 12 patients and improved in 9 patients. Iodine-125 plaque therapy appears to offer patients good prospects of tumour control and preservation of useful vision.

Forty eight eyes of 42 patients with choroidal neovascular membranes and age-related macular degeneration who received three different dose regimens of systemic interferon alfa-2 were studied retrospectively. The A recent report suggests that systemic interferon alfa-2a treatment may inhibit the growth of choroidal neovascular membranes in eyes with age-related macular degeneration.6 Seven patients with well defined subfoveal membranes were treated with systemic interferon alfa-2a for about 6 weeks. Six patients showed resolution of the membrane on treatment, improved acuity, and smaller scotomas. The diameter of the choroidal neovascular membrane was one disc diameter (1 DD) or less in all six eyes in which the membrane regressed.Systemic interferon alfa-2 has been used clinically to treat vascular tumours, including pulmonary haemangiomatosis7 and haemangioendotheliomas.8 The antiangiogenic activity of interferon is not entirely understood. Interferon alfa inhibits vascular endothelial cell proliferation in vitro, possibly through the induction of 2',5'-oligoadenylate synthetase which leads to the degradation of viral and cellular RNA.9We present herein a retrospective analysis of 48 eyes of 42 patients with age-related macular degeneration who received systemic interferon alfa-2 (either 2a or 2b) treatment for active choroidal neovascular membranes. These patients were treated around the end of 1991 by several groups of Sydney ophthalmologists acting independently and using different protocols. The large number of patients treated no doubt reflects the public awareness of interferon alfa as a treatment for age-related macular degeneration, which was due to a number of reports in the media at that time. The goal of this study was to examine the effects of interferon alfa on the growth and activity of choroidal neovascular membranes in a large group of patients.