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July/August 2004

Lauralyn Gordon
Maine Eye Center Portland, Me.

The answer to this month’s mystery image:

Intravitreal Kenalog

Intravitreal triamcinolone acetonide (Kenalog) has become a popular treatment for diabetic cystoid macular edema refractory to other treatment modalities such as laser photocoagulation. This 53-year-old diabetic man had an injection of 4 milligrams/0.1 milliliter intravitreal triamcinolone acetonide suspension through the inferior pars plana. A small amount of the suspension entered the premacular bursa. This image, taken approximately 10 minutes postinjection, defines the cisternal anatomy of the vitreous. The medication resorbed by one week, and the patient realized several lines of visual improvement.

Some surgeons now advocate intraocular triamcinolone to highlight vitreous planes during surgery.

Blink is edited by Richard E. Hackel, MA, CRA, FOPS