Hi, I'm Sunir Garg. I'm Chief of the Retina Service at Wills Eye Hospital, and I'm here at the ASRS annual meeting in Montreal. I just gave a talk on the role of suprachoroidal triamcinolone acetonide to treat chronic cystoid macular edema. It's been five years since suprachoroidal triamcinolone was approved for the treatment of uveitic macular edema, and we have some smaller studies that have looked at its role in CME, but we still don't have a lot of real world data on patients with CME. So we sought to determine the durability and the safeties defined as IOP of suprachoroidal triamcinolone to treat eyes with CME. This was a retrospective review of the Vestrum Health database. We looked at patients who had their first suprachoroidal injection. We had a six-month period that we followed them before, and then 12-month period that we looked at afterwards. Overall, we identified 650 patients, and what we found is when patients had their first suprachoroidal triamcinolone injection, on average, if they needed another shot, it was about 130 days later.

If they needed a third shot of some steroid, it was on average a hundred days later. What's more interesting to me is if you looked at the patients who then got three consecutive suprachoroidal injections compared to those who had one suprachoroidal injection and then got switched to a different steroid. If you look at patients who stayed with suprachoroidal triamcinolone, they were able to go about 130 days in between shots, whereas those who started with one but it switched to something else, they got re-treated about three months later. And that was also true when we did a sub-analysis on the eyes with CME. The other thing that was quite favorable in both groups was the number of patients who had an IOP rise of 10 millimeters mercury or more. It was a little over 20%. Those that had an IOP rise of 25 or more was about three to 4%.

And it's really remarkable to me that the IOP rise was comparatively low, given that more than half the patients in each group who had an IOP rise had baseline glaucoma. And of course, those are eyes that would've been excluded from the pivotal studies. So in summary, seems like suprachoroidal triamcinolone cenide works well for chronic CME. It lasts for about four months, which is about a month longer than other injectable steroids, and has a favorable safety profile with IOP rides being pretty low and quite manageable. Thank you.