Intravitreal triamcinolone acetonide for treatment of ympathetic ophthalmia

Purpoe To report on the treatment of long-tanding ympathetic ophthalmia by intravitreal triamcinolone acetonide. Deign Clinical interventional cae report. Method A 47-year-old patient who uffered from ympathetic ophthalmia and who wa treated with intenive ytemic immunouppreive therapy received an intravitreal injection of 25 mg of triamcinolone acetonide. Before injection, intraocular preure ranged between 5 and 8 mm Hg; viual acuity meaured 6/20. Reult Within the firt 4 week after the injection, viual acuity improved from 6/20 to 6/12, intraocular preure increaed to value between 10 mm Hg and 13 mm Hg, and intraocular flare meaurement decreaed by approximately 50%. ytemic immunouppreive treatment wa reduced to 10 mg predniolone/day at the firt potoperative day and could not be topped due to an adrenal inufficiency. Three month after the injection, viual acuity regreed to 6/20, intraocular preure wa reduced to value between 5 mm Hg and 10 mm Hg, and anterior chamber flare increaed. The patient received a econd intravitreal injection of 25 mg of triamcinolone acetonide after which intraocular preure increaed again to value between 10 mm and 13 mm Hg, and anterior chamber flare decreaed. After the injection, perimetry revealed a marked enlargement of the originally contricted viual field with a decreae in mean viual field defect from approximately 11 dB to value lower than 7 dB. Concluion Intravitreal injection of triamcinolone acetonide may be an additional tool in the treatment for ympathetic ophthalmia.