Periocular Triamcinolone Acetonide Injections for Cystoid Macular Edema Complicating Noninfectious Uveitis

Purpose: To describe the effectiveness of periocular corticosteroid injections in the treatment of cystoid macular edema (CME) complicating noninfectious uveitis. DESIGN: Retrospective cohort study. METHODS: A total of 126 patients (156 eyes) were evaluated for presence of CME, visual acuity, intraocular pressure, degree of intraocular inflammation, and the presence of ocular complications. Main outcome measures included resolution of CME and visual acuity at the 1- and 3-month visits, failure of periocular injection therapy, and side effects. RESULTS: Twenty-eight percent of the 156 eyes had anterior uveitis, 22% intermediate uveitis, and 31% panuveitis. Of these eyes, 53% demonstrated clinical resolution of CME at 1 month and 57% at 3 months after a single periocular corticosteroid injection. Forty eyes were treated with >1 periocular injection because the CME persisted 1 month after the first injection (1 additional injection in 21 eyes; 2 additional injections in 14 eyes; >2 additional injections in 5 eyes). For the 21 eyes treated with a second periocular corticosteroid injection, 81% had no CME 1 month after the second injection and 48% had no CME 3 months after the second injection. Twenty-three eyes (15%) failed periocular corticosteroid therapy. Of eyes initially responding to periocular injection, CME recurred in 53% (median time to recurrence = 20.2 weeks). A halving of the visual angle was observed in 52% and 57% at the 1 and 3-month visits after injection, respectively. CONCLUSIONS: Fifty-three percent of eyes treated with a single periocular corticosteroid injection had clinical resolution of CME 1 month after the injection. (Am J Ophthalmol 2011;152:441-448. (C) 2011 by Elsevier Inc. All rights reserved.)