Suprachoroidal drug infusion for the treatment of severe subfoveal hard exudates

Retina. 2012 Apr;32(4):776-84. doi: 10.1097/IAE.0b013e3182278b0e.


Purpose: To evaluate the safety, feasibility, and preliminary efficacy of suprachoroidal drug delivery with a microcatheter for the treatment of severe subfoveal hard exudates (SHE) in retinal vasculopathies. Definitive treatments for SHE have not yet been identified and prognosis is unfavorable.

Methods: In this prospective, interventional pilot study, six eyes of six patients with central or branch retinal vein occlusion or diffuse diabetic macular edema accompanied by massive refractory SHE underwent a single treatment with bevacizumab and triamcinolone administered to the submacular suprachoroidal space via a microcatheter introduced at the pars plana and advanced posteriorly. The main outcome measures included best-corrected visual acuity, vascular leakage, macular thickness, extent of SHE, and complications.

Results: Mean follow-up was 12 months. Three eyes had central retinal vein occlusion, one had branch retinal vein occlusion, and two had chronic diabetic macular edema. Best-corrected visual acuity improved by ≥2 lines in 4 eyes and remained stable in 2 eyes. At 1 month to 2 months postprocedure, SHE was almost completely resolved in all eyes and macular edema was significantly reduced. There were no surgical or postoperative complications.

Conclusion: Suprachoroidal infusion of drugs can be effective in reabsorbing massive SHE.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / administration & dosage
  • Anti-Inflammatory Agents / administration & dosage*
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Bevacizumab
  • Catheterization / methods
  • Diabetic Retinopathy / drug therapy*
  • Exudates and Transudates*
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Macular Edema / drug therapy*
  • Male
  • Microsurgery
  • Middle Aged
  • Pilot Projects
  • Prospective Studies
  • Retinal Vein Occlusion / drug therapy*
  • Triamcinolone Acetonide / administration & dosage*
  • Visual Acuity


  • Angiogenesis Inhibitors
  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal, Humanized
  • Bevacizumab
  • Triamcinolone Acetonide