Intravitreal triamcinolone acetonide in exudative age-related macular degeneration

Purpose: To examine the effects of intravitreal injection of 4.0 mg triamci nolone acetonide on the visual and clinical course of exudative age-related macular degeneration. Methods: A randomized clinical trial of a single injection of triamcinolone acetonide into the vitreous cavity of experimental eyes at baseline versus observation of untreated subjects was performed in 27 patients followed up for 6 months. Inclusion criteria included exudative age-related macular de generation with subfoveal or occult choroidal neovascularization, and visua l acuity between 20/40 and 20/400. Examination, acuity assessment, fundus p hotography, and fluorescein angiography were performed at baseline and at 3 and 6 months after enrollment. LogMAR visual acuity was compared between g roups by a repeated measures analysis of variance model, Masked assessment of photographic studies was performed and groups were compared with Fisher' s exact test. Results: Visual acuity was significantly better in the treated group compar ed with control subjects at 3 and 6 months (P < 0.005). Fundus photography and angiography were more likely to show stability or improvement at 3 and 6 months in the treated group (P = 0.05). Intraocular pressure elevation wa s seen in 25% of treated patients, but was controlled with topical medicati ons. Progression of cataract was more frequently seen in the treated group. Conclusions: Intravitreal triamcinolone acetonide may provide short-term im provement in visual acuity and fundus findings in exudative macular degener ation. These findings must be considered preliminary and should be followed by multicenter, masked, placebo-controlled trials with long-term follow-up .