Ultrasonographic Pictures of Intravitreal Triamcinolone Acetonide

Abstract

Purpose To evaluate ultrasonographic pictures of intravitreal triamcinolone acetonide (IVTA). Methods Twenty-eight eyes from 28 patients who needed intravitreal injection of triamcinolone acetonide (4 mg/0.1 mL) were included in this study. A baseline ocular B-scan ultrasound examination was performed in all eyes before IVTA injection. Subsequent examinations were scheduled about 1 hour, 1 day, and 1 week after the injection and thereafter weekly up to complete sonographic disappearance of triamcinolone acetonide. Ultrasonographic pictures of IVTA and disappearance time of the medication were evaluated. Results In all the eyes, IVTA was seen as multiple inhomogeneous markedly hyperechoic areas with various size and shape and nonuniform distribution through the vitreous cavity. Common pictures included localized bright hyper-reflective area, diffuse bright point-like echo sources, membranous surfaces, and subhyaloid opacities. IVTA deposited along acoustic interfaces and changed their ultrasonographic characteristics. IVTA facilitated visualization of posterior vitreous surface in seven patients. Opacities due to IVTA gradually cleared over a 3- to 7-week period. Conclusions The findings indicate that IVTA has a bright hyper-reflective ultrasonic image and should be considered as a differential diagnosis for vitreous opacity. IVTA can change the ultrasonographic pattern of the vitreous cavity and highlight membranous surfaces.