Intereye Difference in Exudative Age-related Macular Degeneration With Minimally Classic or Occult Subfoveal Neovascularization After Unilateral Intravitreal Injection of Triamcinolone Acetonide

Jonas, Jost B.; Spandau, Ulrich; Harder, Ben; Vossmerbaeumer, Urs; Kamppeter, Bernd A.

doi:10.1016/j.ajo.2005.01.032

Cited by 30 publications

(24 citation statements)

References 38 publications

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“…15 Considering that the patients included in the present study complained about a progressive loss of vision prior to the injection, the results of the present study are also in agreement with another study from the same group of authors in which patients receiving an intravitreal injection of triamcinolone acetonide performed significantly better than patients of a nonrandomized control group; and the results of the present study are in agreement with another investigation in which the injected eyes had a significantly better outcome than the contralateral nontreated eyes in patients with bilateral exudative age-related macular degeneration. 18,20 Comparing the results obtained at 6 months and at 12 months after the injection in present study with results reported for a combined treatment of intravitreal triamcinolone acetonide and verteporfin photodynamic therapy suggests that the combined treatment may be superior to the intravitreal triamcinolone acetonide monotherapy. 16,[30][31][32][33][34][35] Spaide et al 16 were the first to report on the combination of intravitreal triamcinolone acetonide with photodynamic therapy as treatment of exudative age-related macular degeneration.…”

Section: Discussionmentioning

confidence: 46%

“…The studies have not been conclusive about the therapeutic value of intravitreal triamcinolone acetonide for treatment of exudative age-related macular degeneration. Some small-scaled case-series investigations using the dosage of about 20 mg triamcinolone acetonide reported a beneficial effect 11,15,18,20 contradicting a previous randomized clinical trial using a dosage of 4 mg triamcinolone acetonide. 14 In view of the different results of the previous investigations and different dosages used, it was the purpose of the present consecutive case-series study to assess in a longer followup patients who had received an intravitreal high-dosage injection of triamcinolone acetonide.…”

Section: Introductionmentioning

confidence: 67%

“…18 In an intereye comparison of patients with bilateral exudative age-related macular degeneration and unilateral intravitreal injection of triamcinolone acetonide, the injected eyes demonstrated a significant gain in visual acuity, while mean visual acuity decreased significantly in the contralateral eyes towards the end of the follow-up. 20 Patients retreated with an intravitreal injection of 20 mg of triamcinolone acetonide showed a significant reincrease in visual acuity after the second intravitreal injection. 17 These clinical studies are in agreement with experimental studies on an angiostatic effect of intravitreal cortisone on experimental subretinal neovascularization and other types of intraocular blood vessel proliferation.…”

Section: Discussionmentioning

confidence: 99%

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Follow-up after intravitreal triamcinolone acetonide for exudative age-related macular degeneration

Jonas

Spandau

Kamppeter

et al. 2006

Eye

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Purpose To report on the follow-up of patients who received an intravitreal triamcinolone acetonide injection (IVTA) as treatment of exudative age-related macular degeneration.Methods The clinical interventional caseseries study included 205 patients (222 eyes) with progressive exudative age-related macular degeneration with subfoveal neovascularization who consecutively received an IVTA of about 20 mg as only therapeutic procedure and for whom follow-up was at least 3 months. Mean follow-up was 10.477.1 months (range, 3-35.7 months). Results Visual acuity improved significantly (Po0.001) from baseline (0.9070.45 logarithm of the minimum angle of resolution (LogMar)) to a mean minimum of 0.7970.42 LogMar during follow-up. In 86 (38.7%) eyes and in 55 (24.8%) eyes, best visual acuity increased by at least two and three Snellen lines, respectively. Comparing the measurements at specific postinjection examination dates showed that visual acuity measurements taken at 1, 2, and 3 months after injection were not significantly different from the baseline value. Measurements taken at 6, 9, and 12 months after the injection were significantly (Po0.001) lower than the measurements at baseline. Mean loss at 6 months was 1.473.8 Snellen lines, at 9 months, 2.574.6 lines, and at 12 months after the injection, 2.674.0 lines. Intraocular pressure increased significantly (Po0.001) during the first 6 months, and returned to baseline at 9 months after injection.Conclusions Single injection high-dosage IVTA did not show an apparent benefit at 12 months after injection in patients with neovascular age-related macular degeneration.

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Section: Discussionmentioning

confidence: 46%

Section: Introductionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

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Follow-up after intravitreal triamcinolone acetonide for exudative age-related macular degeneration

Jonas

Spandau

Kamppeter

et al. 2006

Eye

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“…IVTA has been discussed to be a possibly useful adjunct to the therapy of exudative AMD [116,117,118,119,120,121,122,123,124,125,126,127,128,129,130,131,132,133,134,135,136,137,138,139,140,141,142,143,144,145,146,147,148,149,150,151,152] since previous studies had shown that TA may have an antiangiogenic and antiedematous effect [112,113,114,115,258,259,260,262,263,264,265,266]. Both neovascularization and retinal edema are characteristics of exudative AMD.…”

Section: Clinical Studies: Ta In Other Ocular Diseasesmentioning

confidence: 99%

Intravitreal Triamcinolone

Tao

Jonas

2010

Ophthalmologica

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Background: To provide an update on the intravitreal use of triamcinolone acetonide. Methods: Review of literature regarding triamcinolone-related research. Results: After the introduction of bevacizumab and ranibizumab into clinical practice, intravitreal triamcinolone has lost its leading position as the drug most often injected intravitreally. Due to its properties as a long-acting steroid, triamcinolone has still been used for various conditions such as diffuse diabetic macular edema, retinal vein occlusions, pseudophakic cystoid macular edema, chronic prephthisical ocular hypotony and uveitis, and in combination with bevacizumab or ranibizumab. The complications of intravitreal triamcinolone therapy include secondary ocular hypertension in about 40% of the eyes injected, cataract and postoperative infectious or noninfectious endophthalmitis. Conclusions: Due to its widespread biological effects as a steroid and due to a relatively large therapeutic window, intravitreal triamcinolone has remained in clinical use for a variety of intraocular disorders, and it may be a promising candidate for intravitreal medical combination therapies.

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“…Following Robert Machemer, Gholam Peyman, and others, [1][2][3][4][5][6] intravitreal triamcinolone acetonide has increasingly been used in recent studies as treatment for other intraocular proliferative, oedematous, and neovascular diseases, such as diffuse diabetic macular oedema, [7][8][9][10][11][12][13] central retinal vein occlusion, [14][15][16][17] branch retinal vein occlusion, [18][19][20] chronic uveitis, [21][22][23][24][25] persistent pseudophakic cystoid macular oedema, [26][27][28][29] exudative age-related macular degeneration, [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] and other diseases. 6 It has remained unclear so far, whether the various ocular disorders differ in their response to intravitreal triamcinolone acetonide in terms of an increase in visual acuity and a rise in intraocular pressure.…”

Section: Introductionmentioning

confidence: 99%

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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Intereye Difference in Exudative Age-related Macular Degeneration With Minimally Classic or Occult Subfoveal Neovascularization After Unilateral Intravitreal Injection of Triamcinolone Acetonide

Cited by 30 publications

References 38 publications

Follow-up after intravitreal triamcinolone acetonide for exudative age-related macular degeneration

Follow-up after intravitreal triamcinolone acetonide for exudative age-related macular degeneration

Intravitreal Triamcinolone

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

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