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Impressum
Regression of Neovascular Iris Vessels by Intravitreal Injection of Crystalline Cortisone
1Soefker A., 2Hayler J. K., Panda-Jonas S., 1,2Jonas J. B.
Department of Ophthalmology and Eye-Hospital, Faculty for Clinical Medicine Mannheim, Ruprecht-Karls-University Heidelberg1; Department of Ophthalmology and Eye Hospital, Friedrich-Alexander-University Erlangen- Nuernberg2
Objective: To report on the clinical outcome of patients who received
an intravitreal injection of crystalline triamcinolone acetonide as treatment
of neovascular glaucoma.
Methods: The study included 14 eyes of 14 patients suffering from
seconddary neovascular glaucoma due to proliferative diabetic retinopathy
(n=9) or ischemic central retinal vein occlusion (n=5). All patients received
an intravitreal injection 20 mg crystalline triamcinolone acetonide as
only procedure (n=4), or in combination with additional procedures such
as goniosynechiolysis when the anterior chamber angle was circumferentially
closed (n=1), phacoemulsifikation and intraocular lens implantation (n=2),
or transscleral peripheral retinal cryocoagulation (n=7). Mean follow-up
time was 3.10 ± 2.40 months (mean ± S.D.; median, 3.5 months;
range, 0.50 - 5.7 months).
Results: Intraocular pressure was significantly (p<0.01) reduced
from 33.4 ± 14.5 mmHg preoperatively to 20.7 ± 8.2 mmHg
at the end of the follow-up period. Postoperative visual acuity (0.09
± 0.07 (median, 0.10; range, finger counting to 0.25)) was slightly,
however not significantly (p=0.02) better than the preoperative values.
Degree of rubeosis iridis decreased significantly from 2.6 ± 1.3
relative units to 1.3 ± 1.2 relative units. Considering only the
four patients for whom the intravitreal injection of crystalline cortisone
was the only procedure performed, mean intraocular pressure decreased
from 26.5 ± 12.1 mmHg to 21.75 ± 11.3 mmHg.
Conclusion: Intravitreal injection of crystalline cortisone with
most of the vehicle removed may be a potentially useful additional tool
in the treatment of neovascular glaucoma.