Wydanie 3/2007

Wczesne wyniki doszklistkowego podania triamcynolonu u pacjentów z zaawansowaną wysiękową postacią AMD i niską ostrością wzroku

Early Results of the Intravitreal Triamcinolone Acetonide in Patients with Late Stage of wet AMD and Low Visual Acuity

Katarzyna Mozolewska-Piotrowska, Karol Krzystolik, Monika Drobek-Słowik

Katedra i Klinika Okulistyki Pomorskiej Akademii Medycznej w Szczecinie Kierownik: prof. dr hab. n. med. Danuta Karczewicz

Summary: Aim: evaluation of intravitreal triamcinolone acetonide (IVTA) influence on the course of wet AMD in patients with late stage of the disease and low visual acuity. Patients and methods: intravitreal injection of 20 mg of triamcinolone acetonide was performed in 20 eyes of 20 patients aged 65-84 years (mean age 76.6) with late stage of wet AMD with pronounced retinal edema and low visual acuity. Solvent agent was removed using sedimentation method. Patients did not meet the PDT criteria. Follow-up period was 1-12 months (mean 4 months) while scheduled follow-up period is 12 months. Best corrected visual acuity (Snellen chart), slit lamp and stereoscopic eye fundus examinations, intraocular pressure and fluorescein angiography were performed before and 3 months after treatment. Results: 12 patients reported vision improvement (5 of them regained reading ability), 4 patients observed stabilization and another 4 further decrease in visual function of the treated eye. Best corrected visual acuity improved in 9 eyes (45%), stabilized in 6 (30%) and worsened in 5. Mean visual acuity of the group improved from 0.077 before to 0.11 after treatment, but the difference was not statistically significant for p<0.05. No complications of IVTA were recorded so far, neither due to the injection procedure, nor to triamcinolone itself, except of transient and mild ocular hypertension with IOP not exceeding 24 mmHg. Conclusions: 1. Intravitreal Triamcinolone acetonide may suppress CNV activity, what may lead to decrease in the final scar diameter, specially in patients with the beginning of scar formation accompanied by persistent edema of surrounding retinal tissue. 2. In some patients treatment should be considered despite of late stage of wet AMD and low visual acuity at the time of diagnosis.

Keywords: intravitreal triamcinolone acetonide, age-related macular degeneration.