INTRAVITREAL INJECTION OF CRYSTALLINE CORTISONE AS ADJUNCTIVE TREATMENT OF NEOVASCULAR SECONDARY ANGLE-CLOSURE GLAUCOMA

J.B. Jonas, J. Hayler, A. Sцfker, S. Panda-Jonas

Faculty of Clinical Medicine Mannheim of the University of Heidelberg, Department of Ophthalmology

Purpose. To report on clinical outcome of intravitreal injection of crystalline cortisone. Patients and Methods. The study included nine eyes of nine patients receiving an intravitreal injection of 10 to 20 mg crystalline triamcinolone acetonide as treatment of secondary neovascular angle-closure glaucoma due to proliferative diabetic retinopathy. The intravitreal injection was combined with transscleral retinal cryocoagulation in 7 patients. For two patients, the intravitreal cortisone injection was the only surgical procedure performed at that time and during the follow-up period.  Results. Within the first two weeks postoperatively, the iris neovascularisation pronouncedly regressed, and intraocular pressure was reduced from 37.14 ± 14.50 mmHg preoperatively to 20.0 ± 6.84 mmHg postoperatively. For the two patients for whom the intraocular cortisone injection was the only procedure performed, mean intraocular pressure decreased from 30 mmHg to 22.5 mmHg, and mean visual acuity slighty changed from 0.09 to 0.10 Conclusions. Intravitreal injection of crystalline cortisone with most of the vehicle removed may be a potentially useful additional tool in the treatment of neovascular secondary angle-closure glaucoma.