Intravitreal Reinjection of Triamcinolone for Exudative Age-RelatedMacular Degeneration

Abstract

Objective To evaluate the outcome of repeated intravitreal injections of triamcinoloneacetonide for the treatment of exudative age-related macular degeneration. Methods This prospective, comparative nonrandomized clinical interventionalstudy included 13 patients with progressive exudative age-related maculardegeneration with occult, or predominantly occult, subfoveal neovascularization.All patients had shown an increase or stabilization of visual acuity aftera first intravitreal injection of 25 mg of triamcinolone acetonide. They receiveda second intravitreal injection of 25 mg of triamcinolone acetonide 3.1 to18 months after the first injection. Mean ± SD follow-up time afterthe second injection was 5.2 ± 3.6 months (median, 5.3 months). A controlgroup included 24 patients with exudative age-related macular degenerationwho did not receive treatment for their maculopathy. The main outcome measureswere visual acuity and intraocular pressure. Results In the study group, mean ± SD visual acuity increased significantly(P = .005 and P = .003,respectively) from 0.17 ± 0.11 to 0.32 ± 0.26 and from 0.15± 0.14 to 0.23 ± 0.19, respectively, after the first and secondinjections. An increase in visual acuity was found for 10 patients (77%) afterthe first and second injections. In the control group, visual acuity did notvary significantly during follow-up (P = .81). Thedifference in change in visual acuity between the study group and controlgroup was significant (P = .01 [Snellen lines] and P = .05 [logMAR units]). The peak in visual acuity and,in a chronologically parallel manner, the peak in intraocular pressure elevationoccurred 2 to 5 months after each injection. Conclusions Repeated intravitreal injection of 25 mg of triamcinolone acetonidemay lead to an increase in visual acuity in patients with exudative age-relatedmacular degeneration, with the peak in visual acuity and intraocular pressureelevation occurring about 2 to 5 months after each injection.