Study of the efficiency and safety of subconjunctival triamcinolone acetonide in macular edema

Abstract

Purpose To evaluate through a prospective study the efficiency and safety of triamcinolone in subconjunctival injection on macular edema (ME), in the short and medium term. Patients and methods All the patients included in the study underwent ophthalmologic examination and optic coherence tomography of the macula. The injection of 0.2–0.3 ml (8–12 mg) of triamcinolone was done in the subconjunctival space. We evaluated its efficiency by measuring the best-corrected visual acuity and the central macular thickness at 1, 3, and 6 months. Safety was evaluated by following up the intraocular pressure; the presence or absence of cataract and conjunctival complications at 1, 3, and 6 months; and the glycemic control. Results A total of 44 eyes (36 patients) were included. The overall best-corrected visual acuity and central macular thickness improved after injection. Overall, 67% of diabetic patients required reinjection at the third month. In the cases of inflammatory ME (uveitis and Irvine–Gass), the evolution has remained stable for 6 months after a single injection. No significant variation in intraocular pressure was noted after 1 month (P=0.38), after 3 months (P=0.20), or after 6 months (P=0.13). However, four patients developed ocular hypertension (10 mmHg or more above baseline), which has been well controlled with local monotherapy. Overall, 9.5% of phakic patients developed a cataract at the control of the sixth month. The change in glycated hemoglobin before and after the injection was not significant (P=0.84). Conclusion Subconjunctival triamcinolone acetonide seems to be an interesting and well-tolerated alternative therapy of ME in the short and medium term.

Keywords

• cataract
• intraocular pressure
• macular edema
• subconjunctival
• triamcinolone