ABSTRACT
OBJECTIVE: To evaluate the results of treatment with intravitreal triamcinolone acetonide injection in patients with cystoid macular edema secondary to retinitis pigmentosa. METHODS: This prospective, nonrandomized comparative trial included 20 eyes of 20 patients with cystoid macular edema secondary to retinitis pigmentosa (group A) and 20 eyes of 20 control individuals (group B) with the same characteristics who declined treatment. All treated eyes received an intravitreal injection of 0.1 mL of triamcinolone acetonide (4 mg). The total follow-up was 12 months. The main outcome measures were best-corrected visual acuity, central macular thickness measured by optical coherence tomography, and intraocular pressure. RESULTS: No statistically significant changes were observed in best-corrected visual acuity. Central macular thickness showed statistical differences between the 2 groups. Intraocular pressure showed a statistically significant increase after the first day, at 1 month, and at 3 months in both groups but no significant increase afterward. CONCLUSIONS: Intravitreal triamcinolone administration may be useful for select cases of cystoid macular edema in patients with retinitis pigmentosa but its efficacy seems to be limited over time. Therefore, to obtain a good anatomical result and an improvement of best-corrected visual acuity, further treatment would be necessary after 6 months.
Subject(s)
Glucocorticoids/therapeutic use , Macular Edema/drug therapy , Retinitis Pigmentosa/complications , Triamcinolone Acetonide/therapeutic use , Adult , Cornea/anatomy & histology , Female , Follow-Up Studies , Humans , Injections , Intraocular Pressure , Macular Edema/diagnosis , Macular Edema/etiology , Male , Middle Aged , Prospective Studies , Tomography, Optical Coherence , Visual Acuity , Vitreous BodyABSTRACT
BACKGROUND: Antioxidants may affect the lipid components of membrane receptors. The purpose of this study was to determine whether treatment with antioxidants after photodynamic therapy for age-related macular degeneration (AMD) improves visual acuity recovery time after a flicker test METHODS: The study was conducted in a university-affiliated ophthalmology clinic in Bologna, Italy, from April 2000 to April 2001. Thirty-five patients (21 men and 14 women aged 55 to 86 years [mean 72 (standard deviation [SD] 8.4) years]) with bilateral AMD and neovascular membranes were enrolled in the study. Patients were randomly assigned to either receive (20 patients) or not receive (15 patients) vitamin E (200 mg/d given orally) and polyunsaturated fatty acids (1,000 mg/d given orally) after photodynamic therapy. The outcome measures were visual acuity (logMAR) after 20, 40 and 60 days, and retinal metabolic function, as evidenced by visual acuity recovery after the Magder flicker test. RESULTS: There was no significant difference in visual acuity between the two groups at 20, 40 or 60 days. At 20 days, the visual acuity recovery time was significantly shorter in the group that received antioxidants than in the group that received photodynamic therapy only (phase II .94 [SD 0.39] minutes vs. 2.56 [SD 0.57] minutes, phase II 2.13 [SD 0.68] minutes vs. 2.83 [SD 0.60] minutes, and phase III 2.19 [SD 0.70] minutes vs. 2.92 [SD 0.65] minutes) (p < 0.001). There was no significant difference between the two groups at 40 or 60 days. INTERPRETATION: Treatment with antioxidants after photodynamic therapy for AMD improves retinal metabolic function in the short term but not in the medium term.
