University of Iowa Health Care

Ophthalmology and Visual Sciences

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Intravitreal Triamcinolone

Contributor: Eric Chin, MD

Photographer: Cindy Montague, CRA

A 57-year-old female presented with chronic diabetic macular edema despite monthly and recent anti-VEGF therapy. The patient received 2 mg intravitreal triamcinolone because she was pseudophakic, had healthy optic nerves with normal intraocular pressure, and had no history of glaucoma.

Her vision in the affected right eye was 20/60, and her intraocular pressure was 14 by tonopen.

Intravitreal Triamcinolone

Dilated fundus exam of the right eye immediately following intravitreal injection of 2 mg (0.05 mL) triamcinolone in the inferotemporal quadrant. The view is hazy from the recent injection, as well as intentional focus in the vitreous. The yellow clumps represent triamcinolone in the vitreous cavity.

Intravitreal Triamcinolone

The purpose of these images is to demonstrate what triamcinolone looks like immediately following injection into the vitreous.

  • Triamcinolone acetonide (Kenalog) is a steroid that may be used for macular edema secondary to diabetes, vein occlusions, inflammatory conditions, etc.
  • The dose use varies, however 2 mg (or 0.05 mL) and 4 mg ( or 0.10 mL) are commonly used, studied, and well tolerated
  • Intravitreal triamcinolone is injected via a similar technique as anti-VEGF therapy; however, it is sometimes preferably injected inferotemporally due to its visibly apparent (non-transparent or “milky”) consistency. Also, a slightly larger gauge needle is sometimes needed (eg 27 or 30 gauge) due to larger particle size.
  • Preservative-free intravitreal Triesence (triamcinolone acetonide, Alcon) may also be used in a very similar fashion.


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Ophthalmic Atlas Images by EyeRounds.org, The University of Iowa are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.

last updated: 9/16/2013
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