Residual triamcinolone acetonide sequestered in the fovea after macular hole repair.

Abstract

PURPOSE:

To report the macular hole closure rate and visual outcomes of patients with residual triamcinolone acetonide in the fovea after macular hole repair.

METHODS:

We reviewed the medical records of consecutive patients who underwent macular hole surgery at our institution between 2005 and 2008. Only patients with visible triamcinolone in the fovea in the first postoperative month were included.

RESULTS:

Six patients with Stage III or IV macular holes were included. All patients underwent pars plana vitrectomy, internal limiting membrane peeling, and gas tamponade. Triamcinolone acetonide was used to visualize the vitreous in every patient, and diluted indocyanine green was used to stain the internal limiting membrane in five patients. The median preoperative best-corrected visual acuity was 20/200, which improved to a median of 20/40 at the last follow-up. Five patients eventually developed retinal pigment epithelial alterations. Anatomic hole closure was achieved in every patient. The mean follow-up was 23 months (range, 3-36 months).

CONCLUSION:

Residual triamcinolone sequestered in the fovea after macular hole surgery did not affect hole closure or prevent improvement in visual acuity. It is unclear whether the retinal pigment epithelial alterations in our patients represent toxicity or are unrelated to the triamcinolone exposure.

• Authors: John F Payne, Chris Bergstrom, Jiong Yan, Thomas M Aaberg Sr, Sunil K Srivastava
• Journal: Retina (Philadelphia, Pa.) (Retina) Vol. 31 Issue 1 Pg. 148-53 (Jan 2011) ISSN: 1539-2864 [Electronic] United States
• PMID: 20921926 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Coloring Agents
• Gases
• Glucocorticoids
• Triamcinolone Acetonide
• Indocyanine Green

Topics

• Coloring Agents
• Disease Progression
• Epiretinal Membrane (surgery)
• Eyeglasses
• Female
• Follow-Up Studies
• Fovea Centralis (metabolism)
• Fundus Oculi
• Gases (administration & dosage)
• Glucocorticoids (pharmacokinetics)
• Humans
• Indocyanine Green
• Injections, Intraocular
• Intraocular Pressure
• Male
• Middle Aged
• Postoperative Period
• Retinal Perforations (diagnosis, metabolism, physiopathology, surgery)
• Staining and Labeling
• Tissue Distribution
• Tomography, Optical Coherence
• Treatment Outcome
• Triamcinolone Acetonide (pharmacokinetics)
• Visual Acuity
• Vitrectomy (methods)
• Vitreous Body