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Efficacy of intravitreal triamcinolone acetonide for eyes with postvitrectomy diabetic vitreous hemorrhage.

Lee SY, Lee HG, Chung HW, Yoon YH, Kim JG - Korean J Ophthalmol (2007)

Bottom Line: To evaluate the efficacy of intravitreal triamcinolone acetonide (IVT) for the management of postvitrectomy diabetic vitreous hemorrhage.Vitreous hemorrhage was not cleared in 2 eyes, which required surgical procedures.IVT injection may be beneficial for clearing recurrent postvitrectomy Diabetic Vitreous Hemorrhage.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To evaluate the efficacy of intravitreal triamcinolone acetonide (IVT) for the management of postvitrectomy diabetic vitreous hemorrhage.

Methods: The authors conducted a retrospective study of patients with postvitrectomy diabetic vitreous hemorrhage who were administered 4 mg (0.1 cc) of triamcinolone acetonide ophthalmic suspension. Ocular history, adverse events, BCVA, intraocular pressure, external eye examination, slit-lamp biomicroscopy, fundus examination, B-scan ultrasonography, and fundus photography were assessed on day 1, weeks 1, 2, and 4 and months 2 and 3.

Results: There were 19 eyes of 18 consecutive patients with mean follow-up after IVT injection of 28 weeks. Of the 19 eyes, 17 eyes (89%) experienced clearing of vitreous hemorrhage within 1 to 5 weeks (mean, 1.7 weeks) with visible triamcinolone precipitates along with blood clot in the inferior aspect of fundus. Of these 17 eyes, 12 eyes (63%) maintained vitreous hemorrhage-free condition at last follow-up with a mean visual acuity of 20/63 (range, 20/320 20/25), whereas 5 (29%) developed recurrent vitreous hemorrhage after clearing of vitreous hemorrhage. Vitreous hemorrhage was not cleared in 2 eyes, which required surgical procedures.

Conclusions: IVT injection may be beneficial for clearing recurrent postvitrectomy Diabetic Vitreous Hemorrhage.

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Related in: MedlinePlus

Fundus photograph of patient No. 17 showing the inferior peripheral aspect of retina at 1 week after intravitreal triamcinolone injection for recurrent postvitrectomy diabetic hemorrhage. Previous laser photocoagulation scars (upward) and whitish precipitation of triamcinolone with reddish blood clots on the precipitation (downward, arrow) can be seen.
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Figure 1: Fundus photograph of patient No. 17 showing the inferior peripheral aspect of retina at 1 week after intravitreal triamcinolone injection for recurrent postvitrectomy diabetic hemorrhage. Previous laser photocoagulation scars (upward) and whitish precipitation of triamcinolone with reddish blood clots on the precipitation (downward, arrow) can be seen.

Mentions: The visual acuity of 15 eyes at the time of IVT injection ranged from LP to CF, and in 4 eyes the visual acuity was slightly better than CF. Nine eyes had grade 3 VH (severe vitreous hemorrhage with no retinal details and no orange fundus reflex), 2 eyes had grade 2 VH (moderate vitreous hemorrhage with no visible fundus details but with orange fundus reflex) and 8 eyes had grade 1 VH (mild vitreous hemorrhage with visible fundus details). Mean follow-up after IVT injection was 28 weeks (range, 14-37 weeks). The vitreous hemorrhage was cleared in 17 of the 19 eyes (89%) within 1 to 5 weeks (mean, 1.7 weeks); in 11 of these 17 eyes, it was cleared within 1 week (Table 3). The fundus was clearly visible in all 17 of VH clearing eyes, and triamcinolone precipitates were observed along with retained blood clots (Fig. 1). All but one of these 17 eyes had visual improvement, with a mean visual acuity of 20/160 (range, CF to 20/63) within 1 to 5 weeks. At last follow-up, 12 of the 17 eyes maintained VH-free condition with the mean visual acuity of 20/63. (range, 20/320 to 20/25) Of the 17 eyes that cleared, 5 subsequently developed recurrent vitreous hemorrhage, and these underwent air-fluid exchange or vitreous cavity washout. VH was not cleared in 2 eyes, and vitreous cavity washouts were performed.


Efficacy of intravitreal triamcinolone acetonide for eyes with postvitrectomy diabetic vitreous hemorrhage.

Lee SY, Lee HG, Chung HW, Yoon YH, Kim JG - Korean J Ophthalmol (2007)

Fundus photograph of patient No. 17 showing the inferior peripheral aspect of retina at 1 week after intravitreal triamcinolone injection for recurrent postvitrectomy diabetic hemorrhage. Previous laser photocoagulation scars (upward) and whitish precipitation of triamcinolone with reddish blood clots on the precipitation (downward, arrow) can be seen.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2629885&req=5

Figure 1: Fundus photograph of patient No. 17 showing the inferior peripheral aspect of retina at 1 week after intravitreal triamcinolone injection for recurrent postvitrectomy diabetic hemorrhage. Previous laser photocoagulation scars (upward) and whitish precipitation of triamcinolone with reddish blood clots on the precipitation (downward, arrow) can be seen.
Mentions: The visual acuity of 15 eyes at the time of IVT injection ranged from LP to CF, and in 4 eyes the visual acuity was slightly better than CF. Nine eyes had grade 3 VH (severe vitreous hemorrhage with no retinal details and no orange fundus reflex), 2 eyes had grade 2 VH (moderate vitreous hemorrhage with no visible fundus details but with orange fundus reflex) and 8 eyes had grade 1 VH (mild vitreous hemorrhage with visible fundus details). Mean follow-up after IVT injection was 28 weeks (range, 14-37 weeks). The vitreous hemorrhage was cleared in 17 of the 19 eyes (89%) within 1 to 5 weeks (mean, 1.7 weeks); in 11 of these 17 eyes, it was cleared within 1 week (Table 3). The fundus was clearly visible in all 17 of VH clearing eyes, and triamcinolone precipitates were observed along with retained blood clots (Fig. 1). All but one of these 17 eyes had visual improvement, with a mean visual acuity of 20/160 (range, CF to 20/63) within 1 to 5 weeks. At last follow-up, 12 of the 17 eyes maintained VH-free condition with the mean visual acuity of 20/63. (range, 20/320 to 20/25) Of the 17 eyes that cleared, 5 subsequently developed recurrent vitreous hemorrhage, and these underwent air-fluid exchange or vitreous cavity washout. VH was not cleared in 2 eyes, and vitreous cavity washouts were performed.

Bottom Line: To evaluate the efficacy of intravitreal triamcinolone acetonide (IVT) for the management of postvitrectomy diabetic vitreous hemorrhage.Vitreous hemorrhage was not cleared in 2 eyes, which required surgical procedures.IVT injection may be beneficial for clearing recurrent postvitrectomy Diabetic Vitreous Hemorrhage.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To evaluate the efficacy of intravitreal triamcinolone acetonide (IVT) for the management of postvitrectomy diabetic vitreous hemorrhage.

Methods: The authors conducted a retrospective study of patients with postvitrectomy diabetic vitreous hemorrhage who were administered 4 mg (0.1 cc) of triamcinolone acetonide ophthalmic suspension. Ocular history, adverse events, BCVA, intraocular pressure, external eye examination, slit-lamp biomicroscopy, fundus examination, B-scan ultrasonography, and fundus photography were assessed on day 1, weeks 1, 2, and 4 and months 2 and 3.

Results: There were 19 eyes of 18 consecutive patients with mean follow-up after IVT injection of 28 weeks. Of the 19 eyes, 17 eyes (89%) experienced clearing of vitreous hemorrhage within 1 to 5 weeks (mean, 1.7 weeks) with visible triamcinolone precipitates along with blood clot in the inferior aspect of fundus. Of these 17 eyes, 12 eyes (63%) maintained vitreous hemorrhage-free condition at last follow-up with a mean visual acuity of 20/63 (range, 20/320 20/25), whereas 5 (29%) developed recurrent vitreous hemorrhage after clearing of vitreous hemorrhage. Vitreous hemorrhage was not cleared in 2 eyes, which required surgical procedures.

Conclusions: IVT injection may be beneficial for clearing recurrent postvitrectomy Diabetic Vitreous Hemorrhage.

Show MeSH
Related in: MedlinePlus