Suprachoroidal Triamcinolone Acetonide in Noninfectious Uveitic Macular Edema: A Systematic Review of Evolving Clinical Evidence
In brief
Suprachoroidal triamcinolone adds 7-16 ETDRS letters to vision in noninfectious uveitic macular edema
A systematic review of 14 trials and real-world cohorts found that suprachoroidal triamcinolone consistently improved visual acuity by 7 to 16 letters and thinned the macula by about 150-200 µm, while intraocular pressure spikes above 30 mmHg occurred in fewer than 10% of eyes. Cataract risk was low, and benefits extended to children and eyes refractory to other steroid injections, though longer comparative studies are still needed.
- Journal
- Ocular immunology and inflammation (Q2)
- Published
- 8 September 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Ali Dal, Murat Erdağ, Mehmet Çitirik
- PMID
- 42708385
- DOI
- 10.1080/09273948.2026.2730451
Why clinicians should know about it
- Picked for Anatomy (top studies of the week, 13 September 2026): Suprachoroidal triamcinolone for uveitic macular edema
- Picked for Ophthalmology (top studies of the week, 13 September 2026): Systematic review of suprachoroidal triamcinolone for non‑infectious uveitic macular edema
Abstract
Purpose: Macular edema is a leading cause of vision loss in noninfectious uveitis (NIU). Suprachoroidal triamcinolone acetonide (CLS-TA) has emerged as a targeted corticosteroid delivery strategy with a favorable anatomical and functional profile. This systematic review aimed to evaluate the efficacy and safety of CLS-TA in NIU-associated macular edema by synthesizing evidence from clinical trials and real-world studies.Methods: A comprehensive search of PubMed, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL), supplemented by manual screening of reference lists, was conducted from database inception to March 1, 2026. Fourteen studies were included, comprising randomized controlled trials, post hoc and extension analyses, and real-world observational cohorts. Due to overlapping patient populations, a descriptive synthesis was performed.Results: Across studies, CLS-TA demonstrated consistent improvements in best-corrected visual acuity (BCVA), ranging from +7 to +16 ETDRS letters, alongside significant reductions in central macular thickness (CMT) of approximately 152 to 200 µm. Clinically significant intraocular pressure (IOP) elevation (≥30 mmHg) occurred in fewer than 10% of patients in controlled trials and 11.8% in real-world cohorts, with prior glaucoma or ocular hypertension identified as a key risk factor. Cataract progression over 24 to 48 weeks of follow-up was infrequent and comparable to control groups.Emerging evidence supports the efficacy of CLS-TA in broader clinical contexts, including pediatric uveitis, mixed-etiology cystoid macular edema, and cases refractory to sub-Tenon corticosteroid therapy.Conclusions: Suprachoroidal CLS-TA represents an effective and well-tolerated treatment option for NIU-associated macular edema, with a favorable safety profile and expanding clinical applicability. Further long-term and comparative studies are warranted to define its role within the evolving therapeutic landscape.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.