Deep intramuscular methylprednisolone for the treatment of cystoid macularoedema in uveitis

Purpose To study the use of intramuscular methylprednisolone in the treatme nt of cystoid macular oedema in patients with uveitis. Methods A total of 32 patients with various types of uveitis with unilatera l cystoid macular oedema were recruited. Patients received 160 mg of intram uscular methylprednisolone into the thigh and were reassessed 6-8 weeks lat er. In 17 patients in whom there had been no significant improvement, a fur ther injection of methylprednisolone was given; a total of 49 injections. Results After a first injection a significant improvement in vision (an inc rease of greater than or equal to2 Snellen lines) was seen in 15 of 32 eyes (47%), and 17 of 32 eyes (53%) showed no significant change. After the sec ond injection 7 of 17 eyes (41%) showed a significant improvement but there was no change in 9 of 17 eyes (53%). Only one eye deteriorated more than 2 lines of Snellen acuity. There were minimal ocular or systemic side effect s associated with this form of treatment. Conclusions Despite limited success, deep intramuscular methylprednisolone may have a role as an alternative mode of treatment in uveitis patients wit h unilateral cystoid macular oedema, thus avoiding the potential hazards of periocular injections. In comparison with orally administered systemic cor ticosteroids, an injection ensures patient compliance and is associated wit h fewer side effects.