Subtenon triamcinolone injection for postoperative cystoid macular edema associated with tafluprost

Abstract

Kazuki Matsuura,1 Ryu Uotani,2 Yuki Terasaka1 1Nojima Hospital, Tottori, Japan; 2Tottori University, Tottori, Japan Purpose: We report the successful treatment of a case of cystoid macular edema (CME) associated with topical tafluprost, which was accompanied by serous retinal detachment (SRD). Case: A 78-year-old woman underwent intraocular lens suture surgery, including anterior vitreous cutting, for crystalline lens dislocation in the right eye. Tafluprost was initiated 12 weeks after surgery. Intraocular pressure (IOP) was controlled at 10–14 mmHg. Visual acuity remained at 20/40–30/40. However, the patient complained of blurred vision (20/200) 9 months after surgery. CME accompanied by SRD was identified by optical coherence tomography (OCT) and treated with subtenon triamcinolone injection. Visual acuity rapidly increased to 20/50, and the volume of SRD decreased in a few days. Discontinuation of tafluprost and initiation of diclofenac eye drops improved visual acuity to 20/40 and resulted in improved OCT findings within a few weeks. Three months after injection, tafluprost was resumed along with diclofenac. No recurrence of CME occurred over the following 3 months, and IOP was controlled at 10–15 mmHg. Conclusion: SRD is considered to be a symptom of treatment-resistant CME, which may lead to poor visual acuity after recovery. In such cases, subtenon triamcinolone injection should be strongly considered at an early stage. Keywords: tafluprost, cystoid macular edema, serous retinal detachment, subtenon triamcinolone