Triesence to treat macular oedema – A Case Series of 143 patients

1. Dr Alex Raffles
2. Dr Andrew Chang

Sydney Retina Clinic and Day Surgery, Sydney, Australia

Purpose-To measure the efficacy and safety of using intravitreal Triesence to treat macular oedema

Method-Case series of 143 patients who received at least one injection of intravitreal Triesence to treat macular oedema between June2009 and December2009. Visual acuity, IOP and central sub-field thickness were measured at regular intervals up to 6 months post injection. This data was retrospectively recorded and analysed

Results were grouped according to diagnosis:
1) diabetic macular oedema,
2) post-surgical macular oedema
3) macular oedema secondary to vein occlusion (BRVO and CRVO separately)
4) macular oedema from other causes

Results

1. DMO
• 33% of patients
• Small improvement VA(0.020.1 improvement logMar)
• Reduction in central sub-field thickness (CST) between 50-200microns

2. BRVO macular oedema
• 20% of patients
• Worsening VA(0.021.2 worsening logMar)
• Reduction in CST between(0-175microns)

3. CRVO macular oedema
• 15% of patients
• Significant improvement VA(0.040.4 improvement logMar)
• Reduction in CST between 75-300microns

4. Macular oedema from other causes(including telangectasia, AMD, uveitis)
• 7% of patients
• Fluctuating VA(-0.42+0.4)
• Reduction in CST between 0-180microns

IOP≥20mmHg @1 month n=11
IOP≥25mmHg @1 month n= 5
IOP≥30mmHg @1 month n=3

No cases of endophthalmitis recorded.

Conclusions-Triesence is widely used to treat macular oedema, albeit in an "off-label" manner and there are no studies that assess the efficacy and safety of this particular use.
This case series would suggest that Triesence is a valid and safe treatment without the side effects of raising IOP and causing endophthalmitis that using Kenalog is known for.