Duration of the effect of intravitreal triamcinolone acetonide as treatment for diffuse diabetic macular edema

Jonas, Jost B.; Degenring, Robert F.; Kamppeter, Bernd A.; Kreissig, Ingrid; Akkoyun, İmren

doi:10.1016/j.ajo.2004.02.025

Cited by 117 publications

(89 citation statements)

References 5 publications

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“…El uso de triamcinolona ha sido tema de múltiples publicaciones (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) en donde se ha visto un beneficio tangible en la reducción del grosor macular y en algunos casos mejoría en la agudeza visual, sobretodo en los estudios iniciales (11)(12)(13)(14). En ellos, se empleó para el tratamiento de edema macular refractario a laserterapia; sin embargo, el efecto del medicamento sigue siendo temporal (20) y en muchas ocasiones se requieren reinyecciones con los riesgos que esto implica (hipertensión ocular, desprendimiento de retina, hemorragia vítrea, endoftalmitis tanto estéril como infecciosa) (29)(30)(31)(32).…”

Section: Gráf 2: Comparación Del Oct Basal Y 6 Mesesunclassified

“…En ellos, se empleó para el tratamiento de edema macular refractario a laserterapia; sin embargo, el efecto del medicamento sigue siendo temporal (20) y en muchas ocasiones se requieren reinyecciones con los riesgos que esto implica (hipertensión ocular, desprendimiento de retina, hemorragia vítrea, endoftalmitis tanto estéril como infecciosa) (29)(30)(31)(32). En otros casos, se ha empleado como adyuvante en la cirugía vitreoretiniana para visualizar mejor la hialoides posterior y poder extraerla con mas eficacia (33,34).…”

Section: Gráf 2: Comparación Del Oct Basal Y 6 Mesesunclassified

“…Sin embargo, en muchos casos no se consigue controlar o disminuir el engrosamiento macular y los resultados visuales en el largo plazo son más bien pobres (10). Otros tratamientos empleados en años recientes, han sido: esteroides intravítreos como la triamcinolona) (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23), fármacos antiangiogénicos (bevacizumab) (24,25) y recursos quirúrgicos (vitrectomía) (26)(27)(28). Todos los anteriores empleados en forma aislada tienen sus ventajas; pero al mismo tiempo, tienen ciertos riesgos así como también efectos transitorios como en el caso de los fár-macos intravítreos (29)(30)(31)(32).…”

Section: Introductionunclassified

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Uso de triamcinolona y bevacizumab en cirugía de faco-vitrectomía 25G para el tratamiento de catarata y edema macular diabético

Mota

Chacón-Lara²,

Hernández-Vázquez

2008

Arch Soc Esp Oftalmol

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RESUMENObjetivo: Evaluar la seguridad y eficacia de la cirugía combinada de facoemulsificación y vitrectomía asistida con triamcinolona y aplicación de bevacizumab intravítreo en pacientes con catarata y edema macular diabético difuso. Pacientes y métodos: Estudio prospectivo, longitudinal, no aleatorizado, ensayo clínico no controlado. Se incluyeron trece pacientes en forma consecutiva que presentaron esencialmente catarata subcapsular posterior y edema macular difuso, a los que se les realizó cirugía de facoemulsificación, vitrectomía a tres puertos 25G asistida con triamcinolona, endofotocoagulación y aplicación de bevacizumab intravítreo. Se realizó seguimiento con medición de agudeza visual, fluorangiografía retiniana y tomografía óptica coherente (OCT) basal, a las 2 semanas, en el primer, tercero y sexto meses. Resultados: Se encontró una mejoría visual de al menos 2 líneas de visión al final del seguimiento en diez de los pacientes. En cuanto al grosor central ARTÍCULO ORIGINAL ABSTRACTObjective: To evaluate the safety and efficacy of combined phacoemulsification and triamcinoloneassisted vitrectomy with intravitreal injection of bevacizumab in patients with cataract and diffuse diabetic macular edema. Methods: In this prospective, non randomized, interventional case series we included 13 eyes of 13 patients with posterior subcapsular cataracts and diffuse macular edema who underwent phacoemulsification, 25G triamcinolone-assisted vitrectomy, endophotocoagulation and had a bevacizumab injection at the end of the procedure. The follow-up consisted of basal best corrected visual acuity, fluorescein angiography, and optical coherent tomography performed at 2 weeks, one, three and six months post-operatively. Results: An improvement in the best corrected visual acuity of at least two lines was seen in 10 of the 13 patients. The basal average central macular thickness initially was 358.23 µ (SD 50 µ) while at the end of follow-up was 216.6 µ (SD 23.2 µ).

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Section: Gráf 2: Comparación Del Oct Basal Y 6 Mesesunclassified

Section: Introductionunclassified

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Uso de triamcinolona y bevacizumab en cirugía de faco-vitrectomía 25G para el tratamiento de catarata y edema macular diabético

Mota

Chacón-Lara²,

Hernández-Vázquez

2008

Arch Soc Esp Oftalmol

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“…13 On the other hand, the intravitreal injection of 25 mg triamcinolone has been reported to have measurable concentration up to 6-8 months after the injection. [14][15][16][17] We performed 25 mg high dose intravitreal triamcinolone injection to circumvent the need for frequent repeated injections, which may predispose the patients to the higher rate of complications associated with the treatment.…”

Section: Introductionmentioning

confidence: 99%

Objective evaluation of cataract progression associated with a high dose intravitreal triamcinolone injection

Chu

Chung

Kwon

et al. 2007

Eye

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Purpose To investigate the progression of cataract after a high dose (25 mg) intravitreal triamcinolone acetonide injection in patients with macular oedema secondary to diabetes and retinal vein occlusion. Methods This prospective interventional case series study included 38 patients (76 eyes) with diabetic retinopathy or retinal vein occlusion diagnosed with clinical examination and fluorescein angiography. The patients were treated with 25 mg IVTA in their one eye with macular oedema and the fellow eyes served as a control. Patients were asked to return the next day and weekly for 1 month and monthly thereafter by 6 months postoperative. The progression of the cataract using photographic evaluation according to the Lens Opacities Classification System III was documented and statistical analysis was done using the Kaplan-Meier survival analysis and the log-rank test. Results Among the 38 treated eyes, there was an increase of cataract degree by 1 grade at the end of 6 months in 10 patients. The types of progressed cataract were PSC in seven patients, cortical in six patients, and nuclear sclerosis in one patient. Six months after the injections, there was a significantly higher rate of progression of PSC (P ¼ 0.023, log-rank test) and cortical opacities (P ¼ 0.011) in the treated group while the progression of nuclear cataract was not significantly different between the treated eye and the control eye. Conclusion A high-dose (25 mg) intravitreal triamcinolone acetonide injection induces the progression of cortical and posterior subcapsular opacity in patients with diabetic macular oedema and retinal vein occlusion.

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“…Intravitreal triamcinolone acetonide injection (IVTA) is being increasingly used to treat patients with macular oedema resulting from a variety of conditions such as diabetes, 1,2 retinal vein occlusion, 3,4 pseudophakia, 5 various types of uveitis, 6 radiation retinopathy, 7 and idiopathic cystoid macular oedema (CME). 8 It has also been tried in patients with choroidal neovascular membranes associated with age-related macular degeneration, 9 presumed ocular histoplasmosis syndrome, or choroiditis.…”

Section: Introductionmentioning

confidence: 99%

Prognostic factors for visual acuity improvement after intravitreal triamcinolone injection

Shulman

Ferencz

Gilady

et al. 2006

Eye

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Purpose In some patients with macular oedema, intravitreal triamcinolone acetonide injection (IVTA) fails to improve visual acuity, although oedema shows clinical and angiographic improvement. Side effects can include increased intraocular pressure, cataract development, and (rarely) endophthalmitis. Our purpose was to identify prognostic factors for visual acuity improvement after IVTA. Methods Data on patients treated by IVTA for macular oedema were retrospectively reviewed. Three months postinjection, visual acuity was rated as 'improved' (two or more Snellen lines gained) or 'nonimproved' (unchanged or worsened). Comparative demographic data and pre-and post-IVTA clinical and fluorescein angiographic findings were analysed with SPSS software. Results Of 57 eyes (57 patients), 27 (47%) improved after IVTA. Initial visual acuity ('good', 'moderate', or 'poor') and aetiology of macular oedema (diabetic, venous occlusion, or pseudophakic) did not differ between the two groups. Improvement occurred in significantly more eyes with clinical or angiographic evidence of cystoid macular oedema (CME) than in those with diffuse retinal thickening (P ¼ 0.04) or diffuse leakage on fluorescein angiography (P ¼ 0.02), respectively, and in significantly more pseudophakic than phakic eyes (P ¼ 0.046). Conclusions Pseudophakia and clinical or angiographic CME, but not aetiology or initial visual acuity, were prognostic of visual acuity improvement after IVTA for macular oedema.

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Duration of the effect of intravitreal triamcinolone acetonide as treatment for diffuse diabetic macular edema

Cited by 117 publications

References 5 publications

Uso de triamcinolona y bevacizumab en cirugía de faco-vitrectomía 25G para el tratamiento de catarata y edema macular diabético

Uso de triamcinolona y bevacizumab en cirugía de faco-vitrectomía 25G para el tratamiento de catarata y edema macular diabético

Objective evaluation of cataract progression associated with a high dose intravitreal triamcinolone injection

Prognostic factors for visual acuity improvement after intravitreal triamcinolone injection

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