Endophthalmitis After Intravitreal Injection of Triamcinolone Acetonide

Wilhelmus, Kirk R.

doi:10.1001/archopht.121.11.1663-a

Cited by 69 publications

(46 citation statements)

References 2 publications

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“…All patients received an intravitreal high-dose injection of triamcinolone acetonide of about 20 mg as single and only procedure and had been evaluated in previous single-disease studies. 6,7,14,18,21,26,30,45,46,8 Age was significantly lowest in the uveitis group than in the other groups. 0.042).…”

Section: Introductionmentioning

confidence: 77%

Visual acuity and intraocular pressure after high-dose intravitreal triamcinolone acetonide in selected ocular diseases

Jonas¹,

Schlichtenbrede²

2007

Eye

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Purpose Within the last 5 years, intravitreal injections of triamcinolone acetonide have been for a wide variety of ocular diseases with intraocular oedema and neovascularization. With clinical experience accumulating, the question arises for which indication the side effects outweigh the therapeutic efficacy of intravitreal triamcinolone monotherapy. Scope Comparing different diseases, increase in visual acuity was lower in patients receiving intravitreal triamcinolone monotherapy for exudative age-related macular degeneration than in patients with diabetic macular oedema, branch retinal vein occlusion, central retinal vein occlusion, uveitis, and pseudophakic cystoid macular oedema. Rise in intraocular pressure was significantly higher in relatively young patients with uveitis than in any other patient group. Conclusions Improvement in vision after intravitreal triamcinolone monotherapy is highest in non-ischaemic diseases with an intraretinal macular oedema such as pseudophakic cystoid macular oedema; it is lower in partially ischaemic diseases with intraretinal macular oedema such as diabetic macular oedema or retinal vein occlusions; and it is lowest in diseases with a primarily subretinal location of the disease such as exudative age-related macular degeneration. For the latter diseases, intravitreal triamcinolone monotherapy is, therefore, no longer up-to-date, particularly with the upcoming intravitreal application of vascular endothelial growth factor blocking drugs. For diseases with intraretinal oedema, the rule of thumb may be that intravitreal triamcinolone increases vision as much as retinal ischaemia and tissue destruction by the underlying disease allow it. The rise in intraocular pressure is higher in relatively young patients with uveitis than in elderly patients with other reasons for macular oedema.

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Section: Introductionmentioning

confidence: 77%

Visual acuity and intraocular pressure after high-dose intravitreal triamcinolone acetonide in selected ocular diseases

Jonas¹,

Schlichtenbrede²

2007

Eye

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“…[37][38][39][40] Systemic and local side effects reported so far include cataract, secondary ocular hypertension, leading in some patients to secondary chronic open-angle glaucoma, [41][42][43] and postinjection infectious endophthalmitis. [44][45][46] Due to its antioedematous and antiangiogenic effects as shown in experimental investigations and clinical studies, [47][48][49][50][51] intravitreal triamcinolone acetonide has additionally been used in previous pilot studies on central retinal vein occlusions. It was the purpose of the present study to evaluate whether intravitreal triamcinolone acetonide may be therapeutically useful to increase visual acuity in patients with long-standing cystoid macular oedema due to branch retinal vein occlusion.…”

Section: Introductionmentioning

confidence: 99%

Branch retinal vein occlusion treated by intravitreal triamcinolone acetonide

Jonas

Akkoyun

Kamppeter

et al. 2004

Eye

146

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Purpose To evaluate the effect of intravitreal triamcinolone acetonide on visual acuity in branch retinal vein occlusion. Methods The prospective comparative nonrandomized clinical interventional study included 28 patients (28 eyes) with branch retinal vein occlusion. The study group consisting of 10 consecutive patients received an intravitreal injection of 20-25 mg of triamcinolone acetonide. The control group including 18 patients did not receive an intravitreal injection. The mean follow-up was 8.774.4 months.

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“…5,6 The technique has now been used in a large number of patients for a variety of indications including idiopathic, postcataract, inflammatory, diabetic, postvenous occlusion, and other forms of CMO. Dosages have varied from 2 1 to 25 mg. 7 Using a 4 mg injection in nonvitrectomised eyes, the mean elimination half-life was found to be 18.6 days, 8 but with significant variation in peak concentrations. Using this dose, detectable triamcinolone could be present for 3 months.…”

Section: Discussionmentioning

confidence: 99%

“…12 It is suggested 14 that formulation constituents, possibly benzyl alcohol 0.99%, may provoke sterile inflammation in a small number of patients. After removing additives by microfiltration, 7 no cases of sterile endophthalmitis were encountered in 454 procedures. It is encouraging that a prospective observer-blinded randomised study, while demonstrating the frequency of IOP rise in the treated group, showed no sightthreatening events in a cohort of 75 eyes observed over 3 years from injection.…”

Section: Discussionmentioning

confidence: 99%

Low-dose intraocular triamcinolone injection for intractable macular oedema and inflammation in patients with uveitis

Das-Bhaumik

Jones

2005

Eye

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Aims To evaluate the efficacy and safety of low-dose (2 mg in 0.05 ml) intraocular triamcinolone injection for patients with uveitis-related cystoid macular oedema and/or intractable intraocular inflammation. Patients and methods Retrospective clinical case series. Results Cystoid macular oedema was eliminated in 24/30 eyes (80%). Intractable intraocular inflammation was eliminated in 4/8 eyes (50%). Snellen visual acuity was improved by two lines or more after 14/36 injections (38.9%). Intraocular pressure rose to above 21 mmHg after 8/36 injections (22%). There were no major complications. Conclusions Low-dose (2 mg in 0.05 ml) intraocular triamcinolone acetonide injection is safe and effective for the management of refractory uveitic macular oedema. Its usefulness in controlling inflammation alone is questionable. Eye (2006) 20, 934-937.

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Endophthalmitis After Intravitreal Injection of Triamcinolone Acetonide

Cited by 69 publications

References 2 publications

Visual acuity and intraocular pressure after high-dose intravitreal triamcinolone acetonide in selected ocular diseases

Visual acuity and intraocular pressure after high-dose intravitreal triamcinolone acetonide in selected ocular diseases

Branch retinal vein occlusion treated by intravitreal triamcinolone acetonide

Low-dose intraocular triamcinolone injection for intractable macular oedema and inflammation in patients with uveitis

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