Improvement in Visual Acuity in Chronic Aphakic and Pseudophakic Cystoid Macular Edema After Treatment With Topical 0.5% Ketorolac Tromethamine

Flach, Allan J.; Jampol, Lee M.; Weinberg, David V.; Kraff, Manus C.; Yannuzzi, Lawrence A.; Campo, Randy V.; Neumann, Albert C.; Cupples, Howard P.; Lefler, W. Hampton; Pulido, José S.; Lavelle, Caroline J.

doi:10.1016/s0002-9394(14)76851-5

Cited by 130 publications

(37 citation statements)

References 13 publications

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“…The treatment of pseudophakic cystoid macular oedema with topical non-steroidal anti-inflammatory medications offers an example of successful topical treatment of a macular disorder in the presence of an intact hyaloid. 18,19 It may be possible to chemically modify SAR 1118 to improve its posterior segment penetration when delivered topically. A recent report of successful reduction of uveitic macular oedema using subcutaneous injection of efalizumab, a humanized antibody directed against a subunit of LFA-1, 20 highlights the therapeutic potential of therapies designed to inhibit LFA-1/ICAM-1.…”

Section: Discussionmentioning

confidence: 99%

Safety, tolerability, and bioavailability of topical SAR 1118, a novel antagonist of lymphocyte function-associated antigen-1: a phase 1b study

Paskowitz

Nguyen

Gehlbach

et al. 2012

Eye

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Purpose A growing body of evidence points to a role for inflammation mediated by lymphocyte function-associated antigen-1 (LFA-1) and its ligand intercellular adhesion molecule-1 in the pathogenesis of diabetic macular oedema. This phase 1b clinical trial assessed the safety, tolerability, and pharmacokinetics of topically administered SAR 1118, a novel LFA-1 antagonist, in human subjects. Methods In this prospective, randomized, double-masked trial, 13 subjects scheduled for vitrectomy received one of three concentrations of topical SAR 1118 (0.1, 1.0, or 5.0%) twice daily for 1 week before surgery. Undiluted aqueous and vitreous samples were collected at surgery and analysed for the concentration of the medication. Results All subjects completed the entire course of medication. The only adverse events reported were instillation site irritation (4/13, 31%) and dysgeusia (3/13, 23%). These were mild and transient, occurring at the highest dose. Mean concentrations (ng/ml) of SAR 1118 in the aqueous humour were 0.25, 37.2, and 101.1 for the 0.1%, 1.0%, and 5.0% dose groups, respectively. SAR 1118 was below the level of detection (0.5 ng/ml) for all vitreous samples except in a single subject who had a history of prior vitrectomy and a dislocated intraocular lens. Conclusions Topical SAR 1118 was safe and well tolerated, and dose-dependent levels of drug were detected in aqueous. However, vitreous levels were below the threshold of detection with the concentrations tested. Further investigation of this medication for posterior segment applications would require intravitreal delivery or chemical modification of the drug.

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Section: Discussionmentioning

confidence: 99%

Safety, tolerability, and bioavailability of topical SAR 1118, a novel antagonist of lymphocyte function-associated antigen-1: a phase 1b study

Paskowitz

Nguyen

Gehlbach

et al. 2012

Eye

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“…Both categories can be provided as eye drops immediately after the CME is diagnosed (clinically and/or angiographically) or after a short period of attendance due to the selflimiting character of the condition. The effectiveness of topically administered NSAIDs is proved by several studies (Miyake et al, 1980;Yannuzzi et l., 1981;Flach et al, 1991;Italian Diclofenac Study Group, 1997) and their use is suggested as alternative to steroids when possible (Warren & Fox, 2008) due to the well-known side effects after long-term administration of steroids (eg. elevation of IOP).…”

Section: Treatmentmentioning

confidence: 99%

Macular Edema and Cataract Surgery

Tsika¹,

Diakonis²,

Karavitaki³

et al. 2013

Cataract Surgery

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“…14,15 This would explain the beneficial effect of corticosteroids and non-steroidal anti-inflammatory drugs. 1,[8][9][10][11][12]15,16 The exact mechanism of action of triamcinolone remains unclear. Intravitreal steroids have been shown to stabilise the blood retinal barrier in patients that have had laser photocoagulation and to reduce the vitreous concentration of vascular endothelial growth factor.…”

Section: Eyementioning

confidence: 99%

Outcome of intravitreal triamcinolone acetonide in postoperative cystoid macular oedema

Konstantopoulos¹,

Williams²,

Luff³

2006

Eye

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Aims To assess the efficacy and safety of intravitreal triamcinolone in the treatment of postoperative cystoid macular oedema (CMO). Methods A retrospective case series review of 21 eyes (20 patients) that had an intravitreal injection of triamcinolone 4 mg for postoperative CMO. Diagnosis was confirmed by fundus fluorescein angiography and/or optical coherence tomography in all eyes. Results Mean age of patients was 71.1 years. CMO had developed following routine phacoemulsification cataract extraction (13 eyes), phacoemulsification cataract extraction complicated by posterior capsule tear and vitreous loss (two eyes), vitrectomy (three eyes), or planned combined phacoemulsification and vitrectomy (three eyes). Mean duration of CMO before triamcinolone injection was 4.9 months. Mean duration of follow-up was 7.4 months. Two eyes required a repeat injection. Mean logarithm of minimum angle of resolution (LogMAR) visual acuity (VA) before treatment was 0.53; at 1 month post injection, this increased significantly to 0.33 (Po0.001). Improvement in VA was maintained throughout follow-up; at 6 months or later, mean LogMAR VA was significantly better than baseline (0.33 vs 0.53, P ¼ 0.02). At the latest review, 43% of eyes had improved Snellen VA by two or more lines and 86% by one or more lines compared to baseline. The remaining 14% had reduced Snellen VA compared to baseline. In the post-injection period, 33% of eyes developed an intraocular pressure of 22 mm Hg or higher and all responded well to short-term topical agents.There were no other post-injection complications. Conclusion Intravitreal triamcinolone results in a rapid improvement in VA that may be sustained for more than 6 months.

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Improvement in Visual Acuity in Chronic Aphakic and Pseudophakic Cystoid Macular Edema After Treatment With Topical 0.5% Ketorolac Tromethamine

Cited by 130 publications

References 13 publications

Safety, tolerability, and bioavailability of topical SAR 1118, a novel antagonist of lymphocyte function-associated antigen-1: a phase 1b study

Safety, tolerability, and bioavailability of topical SAR 1118, a novel antagonist of lymphocyte function-associated antigen-1: a phase 1b study

Macular Edema and Cataract Surgery

Outcome of intravitreal triamcinolone acetonide in postoperative cystoid macular oedema

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