Pars plana vitrectomy with intravitreal triamcinolone: effect on uveitic cystoid macular oedema and treatment limitations

Gutfleisch, Matthias; Spital, Georg; Mingels, A; Pauleikhoff, Daniel; Lommatzsch, Albrecht; Heiligenhaus, Arnd

doi:10.1136/bjo.2006.101675

Cited by 45 publications

(14 citation statements)

References 49 publications

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“…The advantageous effect of pars plana vitrectomy (PPV) on CME has been regularly reported in the noncontrolled studies; large randomized trials have so far not been performed [50,51]. A randomized pilot study [52] (23 eyes) established that PPV had a beneficial effect on visual function and angiographic findings compared to a slighter effect of systemic treatment with steroids and immunosuppressants.…”

Section: Surgical Treatments For Inflammatory Cystoid Macular Edemamentioning

confidence: 96%

Inflammatory cystoid macular edema

Rothová

2007

Current Opinion in Ophthalmology

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Section: Surgical Treatments For Inflammatory Cystoid Macular Edemamentioning

confidence: 96%

Inflammatory cystoid macular edema

Rothová

2007

Current Opinion in Ophthalmology

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“…In addition, immunosuppression may be required to improve inflammation and CME [10,11] . Pars plana vitrectomy has also been shown to improve CME and vision in selected cases [12][13][14] , and intravitreal bevacizumab was recently introduced as a further treatment option [15,16] . Roesel Injections of triamcinolone acetonide (TA) are most commonly given via the intravitreal (IVTA) or posterior periocular route, one of which is the orbital floor.…”

Section: Introductionmentioning

confidence: 99%

Intravitreal and Orbital Floor Triamcinolone Acetonide Injections in Noninfectious Uveitis: A Comparative Study

Roesel

Gutfleisch²,

Heinz³

et al. 2009

Ophthalmic Res

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Purpose: To compare the effect of orbital floor (OFTA) or intravitreal (IVTA) administration of triamcinolone acetonide on visual acuity and chronic cystoid macular edema (CME) in patients with uveitis. Methods: Retrospective study of patients suffering from chronic noninfectious uveitis in whom CME (n = 97) did not respond to systemic corticosteroids and/or immunosuppression combined with acetazolamide. Patients received a single injection of either IVTA (n = 48, group 1) or OFTA (n = 49, group 2). Best-corrected visual acuity, macular edema (fluorescein angiography), uveitis activity, ocular hypertension, and cataract formation were analyzed over the course of 1 year. Results: Improvement in visual acuity (≥2 lines, LogMAR) was noted in 50% (IVTA) and 34% (OFTA) after 3 months (p = 0.23), and in 18% (IVTA) and 20% (OFTA) after 12 months. CME improved in 100% (IVTA) and 76% (OFTA) of the eyes within the first month postoperatively (p = 0.36). Macular edema was reduced in 100% (group 1) and 20% (group 2) after 3 months (p < 0.01). At 1 year, cataract progression was noted in 68% (IVTA) and 27% (OFTA) (p < 0.01). Increased intraocular pressure (>21 mm Hg) was detected in 21% (IVTA) and 0% (OFTA) at 4 weeks (p < 0.01) after injection. Conclusion: Uveitic CME and visual acuity not responding to systemic immunosuppression and acetazolamide may improve after an IVTA and OFTA injection. The effect is mostly transient. While the IVTA injections were more effective for improving CME, ocular hypertension and cataracts developed more often.

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“…Studies on visual outcomes of 20-gauge vitrectomy for uveitic eyes reported improvement in visual acuity in 48-82.8% after surgery for granulomatous and nongranulomatous uveitis [14,15,16,17] and improvement of more than 2 lines in 60-64% [15,40,41]. There are few reports on MIVS for uveitis, and most of them are small case series.…”

Section: Discussionmentioning

confidence: 99%

Comparison between Outcomes of Vitrectomy in Granulomatous and Nongranulomatous Uveitis

et al. 2015

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Purpose: The aim of this study was to compare the outcomes of vitrectomy in granulomatous uveitis and nongranulomatous uveitis insufficiently managed by immunosuppressive therapy. Methods: Thirty-eight eyes with granulomatous uveitis and 17 eyes with nongranulomatous uveitis that underwent vitrectomy for ocular complications between July 2006 and August 2012 were reviewed retrospectively. Visual acuity and ocular inflammation scores before and 6 months after surgery were compared. Patients treated with vitrectomy alone and those in whom vitrectomy was combined with phacoemulsification were analyzed separately. Results: The mean visual acuity improved significantly both in granulomatous and nongranulomatous uveitis. In granulomatous uveitis, the mean inflammation scores decreased significantly both in the anterior segment and in the posterior segment. In nongranulomatous uveitis, the mean inflammation score in the posterior segment decreased significantly, although it did not change in the anterior segment. Conclusion: Vitrectomy was effective for treating ocular complications both in granulomatous uveitis and nongranulomatous uveitis, with favorable outcomes of improved visual acuity and decreased uveitis activity.

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Pars plana vitrectomy with intravitreal triamcinolone: effect on uveitic cystoid macular oedema and treatment limitations

Abstract: Uveitic CME that is unresponsive to systemic immunosuppression and acetazolamide may improve after PPV with additional intravitreal triamcinolone application. The effect seems to be transient in many of the patients. Frequent complications were cataract formation and ocular hypertension.

Cited by 45 publications

References 49 publications

Inflammatory cystoid macular edema

Inflammatory cystoid macular edema

Intravitreal and Orbital Floor Triamcinolone Acetonide Injections in Noninfectious Uveitis: A Comparative Study

Comparison between Outcomes of Vitrectomy in Granulomatous and Nongranulomatous Uveitis

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