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