Combined Intravitreal Triamcenolone Acetonide And Bevacizumab For Refractory Diabetic Macular Edema

Arain, Muhammad Aamir; Muzaffar, Waqar; Farooq, Omer; Azhar, Muhammad Naeem

doi:10.29271/jcpsp.2018.08.603

Cited by 2 publications

(2 citation statements)

References 12 publications

(15 reference statements)

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“…The functional and anatomical outcomes of the association of IVTA with macular laser [ 97 ] or with anti-VEGF [ 96 , 98 ] were comparable to those obtained with macular laser or anti-VEGF as monotherapy and were linked to a higher risk of IOP rise and cataract development.…”

Section: Corticosteroids For the Management Of Dmementioning

confidence: 99%

“… As compared with the other groups, TA eyes had IOP elevation (IOP rise ≥ 10 mmHg or IOP > 30 mmHg) in 50% vs. 10%; cataract development in 60% vs. 14%. Soheilian et al, 2012 [ 96 ] IVTA 4 mg or IV bevacizumab RCT 150 CIDME Randomized treatment with IV bevacizumab or IV bevacizumab + IVTA or grid/focal laser every 3 months as needed 2 years Better VA gain in the bevacizumab group at 6 months, comparable results amongst the 3 groups at 2 years; similar CRT reduction Kriechbaum et al, 2013 [ 95 ] IVTA 8 mg RCT 30 CIDME treatment-naïve eyes Randomized treatment with 1 IVTA or IV 3 monthly bevacizumab with re-treatment at need 1 year BCVA gain higher in the bevacizumab group; CRT reduction similar between groups Higher cataract development in the TA group Zajac-Pytrus et al, 2017 [ 89 ] IVTA 20 mg Prospective interventional study 110 CIDME eyes treatment-naïve or unresponsive to laser Evaluation of efficacy and safety of IVTA 6 months Significant VA gain and CRT reduction until month 3, but not at month 6 IOP rise at month 1 and 3 Arain et al, 2018 [ 98 ] IVTA; IV bevacizumab Prospective interventional study 50 pseudophakic eyes with refractory CIDME Evaluation of efficacy and safety of IVTA + IV bevacizumab …”

Section: Figure A1mentioning

confidence: 99%

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The Treatment of Diabetic Retinal Edema with Intravitreal Steroids: How and When

Salvetat,

Pellegrini,

Spadea

et al. 2024

JCM

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Diabetic macular edema (DME) is a common complication of diabetes mellitus and a leading cause of visual impairment worldwide. It is defined as the diabetes-related accumulation of fluid, proteins, and lipids, with retinal thickening, within the macular area. DME affects a significant proportion of individuals with diabetes, with the prevalence increasing with disease duration and severity. It is estimated that approximately 25–30% of diabetic patients will develop DME during their lifetime. Poor glycemic control, hypertension, hyperlipidemia, diabetes duration, and genetic predisposition are recognized as risk factors for the development and progression of DME. Although the exact pathophysiology is still not completely understood, it has been demonstrated that chronic hyperglycemia triggers a cascade of biochemical processes, including increased oxidative stress, inflammation, activation of vascular endothelial growth factor (VEGF), cellular dysfunction, and apoptosis, with breakdown of the blood-retinal barriers and fluid accumulation within the macular area. Early diagnosis and appropriate management of DME are crucial for improving visual outcomes. Although the control of systemic risk factors still remains the most important strategy in DME treatment, intravitreal pharmacotherapy with anti-VEGF molecules or steroids is currently considered the first-line approach in DME patients, whereas macular laser photocoagulation and pars plana vitrectomy may be useful in selected cases. Available intravitreal steroids, including triamcinolone acetonide injections and dexamethasone and fluocinolone acetonide implants, exert their therapeutic effect by reducing inflammation, inhibiting VEGF expression, stabilizing the blood-retinal barrier and thus reducing vascular permeability. They have been demonstrated to be effective in reducing macular edema and improving visual outcomes in DME patients but are associated with a high risk of intraocular pressure elevation and cataract development, so their use requires an accurate patient selection. This manuscript aims to provide a comprehensive overview of the pathology, epidemiology, risk factors, physiopathology, clinical features, treatment mechanisms of actions, treatment options, prognosis, and ongoing clinical studies related to the treatment of DME, with particular consideration of intravitreal steroids therapy.

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Section: Corticosteroids For the Management Of Dmementioning

confidence: 99%

Section: Figure A1mentioning

confidence: 99%

The Treatment of Diabetic Retinal Edema with Intravitreal Steroids: How and When

Salvetat,

Pellegrini,

Spadea

et al. 2024

JCM

View full text Add to dashboard Cite

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Pharmacological Adjuncts to Vitrectomy Surgery

Savastano¹,

Savastano

Rizzo³

2019

CPD

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Pharmacological adjuncts to vitrectomy surgery are useful tools to better deal with surgery. Their introduction has enriched the therapeutic choice before, during and after operations. Although several classifications could be made to frame adjuncts to vitrectomy, we preferred to divide the pharmacological adjuncts to vitrectomy surgery for therapeutic use in the pre-operatory procedure (neo-adjuvant), for intraoperative use and for post-operatory practice (adjuvant). This type of classification allowed us to explore all the adjuncts based on the timing of their use. The actual interest in vitrectomy surgery is giving rise to considerable interest in new molecules with and without the pharmacological effect that will soon be available for the aid of vitreoretinal surgery.

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Combined Intravitreal Triamcenolone Acetonide And Bevacizumab For Refractory Diabetic Macular Edema

Abstract: Eyes with refractory macular edema showed improvement of visual acuity and reduction of CSFT at three months when treated with combined IVTA and IVB.

Cited by 2 publications

References 12 publications

The Treatment of Diabetic Retinal Edema with Intravitreal Steroids: How and When

The Treatment of Diabetic Retinal Edema with Intravitreal Steroids: How and When

Pharmacological Adjuncts to Vitrectomy Surgery

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