Within the last three years,
triamcinolone acetonide has increasingly been applied intravitreally as treatment option for various intraocular neovascular edematous and proliferative disorders. The best response in terms of gain in visual acuity after the
intravitreal injection of
triamcinolone acetonide was found in eyes with intraretinal edematous diseases such as diffuse diabetic
macular edema,
branch retinal vein occlusion,
central retinal vein occlusion, and pseudophakic
cystoid macular edema. Visual acuity increased and degree of intraocular
inflammation decreased in eyes with various types of non-infectious
uveitis including acute or chronic
sympathetic ophthalmia and Adamantiadis-
Behcet's disease. Intravitreal
triamcinolone may be useful as angiostatic
therapy in eyes with iris neovascularization and proliferative ischemic retinopathies. Possibly, intravitreal
triamcinolone may be helpful as adjunct
therapy for exudative
age-related macular degeneration, possibly in combination with
photodynamic therapy. In eyes with chronic,
therapy resistant,
ocular hypotony, intravitreal
triamcinolone can induce an increase in intraocular pressure and may stabilize the eye. The complications of intravitreal
triamcinolone therapy include secondary
ocular hypertension in about 40% of the eyes injected, cataractogenesis, postoperative infectious and non-
infectious endophthalmitis, and pseudo-
endophthalmitis. Intravitreal
triamcinolone injection can be combined with other intraocular surgeries including
cataract surgery.
Cataract surgery performed some months after the injection does not show a markedly elevated rate of complications. If vision increases and eventually decreases again after an intravitreal
triamcinolone acetonide injection, the injection can be repeated. The duration of the effect of a single
intravitreal injection of
triamcinolone depended on the dosage given. Given in a dosage of about 20mg to non-vitrectomized eyes, the duration of the effect and of the side-effects was 6-9 months. Intravitreal
triamcinolone acetonide may offer a possibility for adjunctive treatment of intraocular edematous and neovascular disorders. One has to take into account the side-effects and the lack of long-term follow-up observations.