Purpose: To evaluate the anatomic and visual outcomes of intravitreal triamcinolone acetonide injection in patients with cystoid macular oedema (CMO) secondary to retinitis pigmentosa (RP).
Methods: Five eyes of five patients with CMO secondary to RP, aged 25-41 years (mean 33.2 years) made up the study population. All eyes had persistent CMO despite medical treatment with 250 mg of oral acetazolamide twice daily for 1 month. Intravitreal injection of 4 mg (0.1 ml) triamcinolone acetonide was offered to treat macular oedema. The visual and anatomic responses were observed, as well as complications related to the injection procedure and corticosteroid medication.
Results: Follow-up periods varied between 6 and 8 months (mean 6.8 months); all patients completed 6 months of follow-up. After intravitreal triamcinolone acetonide injection all patients showed good anatomic response. The baseline median central macular thickness was 418 microm (range 376-626 microm). At 1 month, the median central macular thickness had decreased to 224 microm (range 214-326 microm). At 3 and 6 months, the median central macular thicknesses were 275 microm (range 215-584 microm) and 312 microm (range 239-521 microm), respectively. Recurrent CMO was found in one patient at the 3-month follow-up and in two patients at the 6-month follow-up. Retreatment was performed in these patients. At the 1-month follow-up, no patient was found to have lost vision and two patients showed improvement. At the 3- and 6-month follow-ups, no patient had lost vision from baseline but no patient had maintained their improved visual acuity (VA).
Conclusions: In our small series, all patients showed an anatomic improvement in CMO after intravitreal injection of triamcinolone acetonide. However, in three out of five patients, despite good anatomic results, no improvement in VA was achieved. Because of the limitations of this pilot study, it is difficult to explain why no improvement in VA was achieved despite good anatomic results in some patients. Further study with longer follow-up periods and larger series is warranted to assess the efficacy of the treatment.