Modified triamcinolone acetonide suprachoroidal injection in macular edema secondary to inmune recovery uveitis

Authors

  • Leonardo P. D'Alessandro Centro Médico Viamonte
  • Gustavo Pacheco Centro Médico Viamonte

DOI:

https://doi.org/10.70313/2718.7446.v18.n3.433

Keywords:

suprachoroidal injection, triamcinolone, IRU, macular edem

Abstract

Purpose: to report the use of suprachoroidal injection with triamcinolone acetonide for the treatment of macular edema secondary to immune recovery uveítis. 

Case report: We report a case of an HIV+ patient with a history of inactive cytomegalovirus (CMV) retinitis who developed macular edema and immune recovery uveitis (IRU), treated with a customized suprachoroidal injection of triamcinolone acetonide. The macular edema resolved, and the patient achieved 20/20 visual acuity (VA) without complications after a single suprachoroidal injection.

Conclusions: in the presented case, the suprachoroidal route of administration of triamcinolone acetonide was a safe and effective treatment for CMV-related IRU with uveitic macular edema. Further studies are needed to confirm this novel therapeutic approach.

Downloads

Download data is not yet available.

Author Biographies

  • Leonardo P. D'Alessandro, Centro Médico Viamonte

    Centro Médico Viamonte. Ciudad de Buenos Aires, Argentina.

  • Gustavo Pacheco , Centro Médico Viamonte

    Centro Médico Viamonte. Ciudad de Buenos Aires, Argentina.

References

1. Kempen JH, Min YI, Freeman WR, Holland GN, Friedberg DN, Dieterich DT, Jabs DA; Studies of Ocular Complications of AIDS Research Group. Risk of immune recovery uveitis in patients with AIDS and cytomegalovirus retinitis. Ophthalmology 2006; 113(4): 684-694. doi: 10.1016/j.ophtha.2005.10.067. PMID: 16581429.

2. Rodrigues Alves N, Barão C, Mota C, Costa L, Proença RP. Immune recovery uveitis: a focus review. Graefes Arch Clin Exp Ophthalmol 2024; 262(8): 2703-2712. doi: 10.1007/s00417-024-06415-y.

3. Wykoff CC, Avery RL, Barakat MR, Boyer DS, Brown DM, Brucker AJ, Cunningham ET Jr, Heier JS, Holekamp NM, Kaiser PK, Khanani AM, Kim JE, Demirci H, Regillo CD, Yiu GC, Ciulla TA. Suprachoroidal space injection technique: expert panel guidance. Retina 2024; 44(6): 939-949. doi: 10.1097/IAE.0000000000004087.

4. Zakaria YG, Salman AG, Said AMA, Abdelatif MK. Suprachoroidal versus intravitreal triamcinolone acetonide for the treatment of diabetic macular edema. Clin Ophthalmol 2022; 16: 733-746. doi: 10.2147/OPTH.S351853.

5. Bhattacharyya S, Hariprasad SM, Albini TA, Dutta SK, John D, Padula WV, Harrison D, Joseph G. Suprachoroidal injection of triamcinolone acetonide injectable suspension for the treatment of macular edema associated with uveitis in the United States: a cost-effectiveness analysis. Value Health 2022; 25(10): 1705-1716. doi: 10.1016/j.jval.2022.07.008.

6. Nawar AE. Effectiveness of suprachoroidal injection of triamcinolone acetonide in resistant diabetic macular edema using a modified microneedle. Clin Ophthalmol 2022; 16: 3821-3831. doi: 10.2147/OPTH.S391319.

7. Marashi A, Baba M, Abu Ghedda S, Kitaz MN, Zazo A. A combination of suprachoroidal injection of triamcinolone using a custom-made needle and intravitreal Ziv-aflibercept every eight weeks to manage naïve/denovo central DME: a single-center retrospective case series. Int J Retina Vitreous 2024; 10(1): 30. doi: 10.1186/s40942-024-00550-8.

8. Fung S, Syed YY. Suprachoroidal space triamcinolone acetonide: a review in uveitic macular edema. Drugs 2022; 82(13): 1403-1410. doi: 10.1007/s40265-022-01763-7. (errata publicada en: Drugs 2022; 82(13):1411. doi: 10.1007/s40265-022-01777-1).

9. Singh P, Krishnaprasad R, Ayachit G, Joshi S. Evaluation of clinical outcomes of raised intraocular pressure following intravitreal triamcinolone acetonide injection. Rom J Ophthalmol 2024; 68(1): 37-44. doi: 10.22336/rjo.2024.08.

10. El-Bradey MH, Cheng L, Song MK, Torriani FJ, Freeman WR. Long-term results of treatment of macular complications in eyes with immune recovery uveitis using a graded treatment approach. Retina 2004; 24(3): 376-382. doi: 10.1097/00006982-200406000-00007.

11. Rothova A, Ten Berge JC, Vingerling JR. Intravitreal aflibercept for treatment of macular oedema associated with immune recovery uveitis. Acta Ophthalmol 2020; 98(7): e922-e923. doi: 10.1111/aos.14451.

12. Dalessandro L, Bottaro E. Reactivation of CMV retinitis after treatment with subtenon corticosteroids for immune recovery uveitis in a patient with AIDS. Scand J Infect Dis 2002; 34(10): 780-782. doi: 10.1080/00365540260348644.

13. Yeh S, Khurana RN, Shah M, Henry CR, Wang RC, Kissner JM, Ciulla TA, Noronha G; PEACHTREE Study Investigators. Efficacy and safety of suprachoroidal CLS-TA for macular edema secondary to noninfectious uveitis: phase 3 randomized trial. Ophthalmology 2020; 127(7): 948-955. doi: 10.1016/j.ophtha.2020.01.006.

Downloads

Published

2025-09-18

Issue

Section

Case Report

How to Cite

1.
D'Alessandro LP, Pacheco G. Modified triamcinolone acetonide suprachoroidal injection in macular edema secondary to inmune recovery uveitis. Oftalmol. clín. exp. 2025;18(3):e351-e360. doi:10.70313/2718.7446.v18.n3.433

Similar Articles

1-10 of 155

You may also start an advanced similarity search for this article.