Loss of visual function after repeated intravitreal injections of triamcinolone acetonide in refractory uveitic macular oedema.

PURPOSE: The effects of intravitreal triamcinolone acetonide on macular oedema have been evaluated in many studies. Good short-time effects are usually reported on visual function and macular oedema. However, adverse events like intraocular hypertension and cataract formation have been described in humans, and retinal toxicity is found in experimental studies. CASE REPORT: We report on a 56-year-old male patient with a bilateral macular oedema in idiopathic intermediate uveitis, treated with two and six intravitreal injections of triamcinolone acetonide, respectively, and followed for 6 years.
RESULTS: The macular oedema disappeared after each intravitreal injection, but each time it recidivated some months later. Visual acuity improved only after the first injections. After six intravitreal injections, visual acuity was limited to counting fingers in the absence of macular oedema. OCT and ERG results show central and peripheral retinal damage that could be a consequence of a retinotoxic property of triamcinolone acetonide.
CONCLUSION: Repeated intravitreal injection of triamcinolone acetonide does not show any long-term efficacy on uveitic macular oedema and can even lead to irreversible global retinal damage.