Topic: 2008: Intravitreal triamcinolone for macular edema in Lyme
CaliforniaLyme
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Yet another example of long-term cure from short term antibiotics!!! (being sarcastic) ******************************************* 1: Graefes Arch Clin Exp Ophthalmol. 2008 Jan 12
Intravitreal triamcinolone for macular edema in Lyme disease.
Reibaldi M, Faro S, Motta L, Longo A. Eye Clinic, University of Catania, via Santa Sofia 78, Catania, Italy, [email protected].
BACKGROUND: To describe the outcome in a patient with macular edema caused by Lyme disease treated with injection of 4 mg intravitreal triamcinolone.
METHODS: The patient, 2 years after systemic Lyme disease treated with doxycycline for 4 weeks, developed macular edema with serous retinal detachment in one eye (visual acuity: 0.6). After unsuccessful therapy with intravenous ceftriaxone, indomethacin and acetazolamide, 4 mg intravitreal triamcinolone (IVTA) was injected via the pars plana.
RESULTS: Visual acuity improved to 1.0 and macular thickness recovered over 1 month. No changes were found in intraocular pressure. No recurrence of macular edema was seen after 2 years.
CONCLUSIONS: IVTA can restore visual acuity and reduce macular thickness in macular edema caused by Lyme disease. However, since borreliosis is a systemic disease, previous systemic antibiotic treatment is recommended.
PMID: 18193264
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All truth goes through 3 stages: first it is ridiculed: then it is violently opposed: finally it is accepted as self evident. - Schopenhauer Posts: 5639 | From Aptos CA USA | Registered: Apr 2005
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Foggy
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Typical: They neglect to mention triamcinolone, a steroid, & LYme don't mix. Posts: 2451 | From Lyme Central | Registered: Aug 2001
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CaliforniaLyme
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Foggy- when it comes to a few conditions even LLMDs WILL USE STEROIDS- those things include-
optical manifestations which threaten vision (which this was)
pseudotumor cerebri
and dermomyositis
Any LLMD I know would use steroids to save vision... With the eyes it is sometimes the only thing that works!!! Very sincerely, Sarah
-------------------- There is no wealth but life. -John Ruskin
All truth goes through 3 stages: first it is ridiculed: then it is violently opposed: finally it is accepted as self evident. - Schopenhauer Posts: 5639 | From Aptos CA USA | Registered: Apr 2005
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Foggy
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My LLMDs use them selectively as well, but would be cognizant & inform a patient of the pros & cons.
It's not the physiologic steroid doses, but more the theraputic doses that cause Lymies such adverse reactions. It's MDs who throw them at various non-emmergent conditions that cause the problems.
[ 16. January 2008, 01:42 PM: Message edited by: Foggy ]
Posts: 2451 | From Lyme Central | Registered: Aug 2001
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