Management of inflammatory macular edema (ME) with ILUVIEN and top up triamcinolone (TCA) injections
Purpose
Case report of inflammatory ME management with ILUVIEN (0.2 µg fluocinolone acetonide, FAc) and top up injections with 2mg TCA.
Methods
In 2013, a 52-year-old male patient, previously diagnosed with sarcoidosis, was referred for reduced visual acuity (VA) in the left eye (LE). Baseline VA was <1/10 Snellen in the right eye
(RE) and 7/10 in the LE. OCT displayed bilateral inflammatory ME with ellipsoid band atrophy.
in the RE.
Results
The patient was treated initially with intravitreal TCA injections bilaterally. Posteriorly the RE was maintained on TCA injections and the LE was treated with the dexamethasone implant. In 2017, both eyes underwent phacoemulsification for posterior subcapsular cataracts. VA following surgery was <1/10 RE and 5/10 LE. Intraocular pressure (IOP) ranged 12-18 mmHg untreated. Due to frequent recurrence of ME in the LE (q3month), the patient was treated with a FAc implant in 12/2019. Recurrence of ME occurred 3 months following treatment. A top up TCA injection was performed, and the macula remained dry for 5 months. Thereafter, a TCA top up was required every 5 months for successful ME recurrence control in the LE. VA was maintained: <1/10 RE and 5/10 LE. An association of brinzolamide+timolol was started at M10 with successful IOP control (12 mmHg). At M37 (2/2023), ME recurrence occurred 2 months after TCA top up. A second FAc was implanted in 3/2023.
Conclusion
Inflammatory ME may occur despite systemic control of the underlying condition. Treatment with the FAc implant allowed for a better control of the inflammatory response. Functional and structural results were maintained throughout the 3-year interval resorting to TCA top up injections.
Conflict of interest
No
Authors 1
Last name
GOUVEIA
Initials of first name(s)
P
Department
Department of Ophthalmology, Hospital de Braga
City
Braga
Country
Portugal
Authors 2
Last name
Gentil
Initials of first name(s)
R
Department
Department of Ophthalmology, Hospital de Braga
City
Braga
Country
Portugal
This website uses cookies to ensure you get the best experience on our website.
Learn more