Background
An intravitreal injection involves placing a medicine into the vitreous or central cavity of the eye. Intravitreal injections have been used for 30 years. Kenalog (triamcinalone acetonide) is a synthetic steroid which is similar to prednisone. Kenalog was first placed in the vitreous cavity in the 1980’s and found to be safe.

Steroid medications reduce inflammation and also affect blood vessels by acting upon the microscopic capillaries. Steroids “tighten” capillaries and reduce leakage. Researchers studied Kenalog because they felt it might prove useful in eye conditions where leakage is occurring in the retina.

Evidence
Intravitreal Kenalog has been used in numerous conditions where retinal edema (swelling) is present. These include diabetic retinopathy, central retinal vein occlusion, branch retinal vein occlusion, and exudative macular degeneration. Researchers have found that a significant number of patients experience a decrease in macular edema and an improvement or stabilization in vision following intravitreal Kenalog.

Procedure
Intravitral Kenalog placement is a brief and typically painless in-office procedure. Following topical anesthesia, intravitral Kenalog is injected into the central cavity of the eye using a fine needle through the white of the eye.

Risks
Risks of the procedure include inflammation, retinal detachment, hemorrhage, infection, and cataract formation. These are uncommon. The most common side effect is a temporary elevation of intraocular pressure which is usually controlled with eye drops.

Comment
Intravitreal Kenalog carries with it certain risks, but may be a valuable alternative for patients who are progressively losing vision due to macular edema.