Intraocular and Systemic Pharmacokinetics of Triamcinolone Acetonide after a Single 40-mg Posterior Subtenon Application

Shen, Lijun; You, Yongsheng; Sun, Song Yung; Chen, Yiqi; Qu, Jia; Cheng, Lingyun

doi:10.1016/j.ophtha.2010.03.033

Cited by 55 publications

(32 citation statements)

References 36 publications

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“…We believe that it was due to the synergy of strong but short (30 days) anti-VEGF effect of IVB and weak but long (113 days) anti-inflammatory effect of STA. 28 Comparing the periods of reinjection time, the IVB group showed 2.07 ± 0.73 months, the IVB/STA group showed 3.00 ± 1.10 months. Although there was no statistical difference between the two groups (P = 0.637), the difference of 1 month is meaningful time in the real-world setting.…”

Section: Discussionmentioning

confidence: 94%

Combination therapy of intravitreal bevacizumab with single simultaneous posterior subtenon triamcinolone acetonide for macular edema due to branch retinal vein occlusion

Moon

Kim

Sagong

2016

Eye

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Purpose To evaluate efficacy and safety of combination therapy of intravitreal bevacizumab (IVB) with single simultaneous posterior subtenon triamcinolone acetonide (STA) for treatment of macular edema (ME) secondary to branch retinal vein occlusion (BRVO). Methods This was a prospective, randomized, interventional comparative study conducted in 45 eyes with ME secondary to BRVO who were treated primarily with IVB 1.25 mg (23 eyes, IVB group) or combination therapy of IVB 1.25 mg with a single simultaneous STA 40 mg (18 eyes, IVB/STA group). Reinjections were performed with IVB if optical coherence tomography (OCT) showed recurrent ME associated with decreased visual acuity. The main outcome measurement was the number of additional IVB injections, and changes of best-corrected visual acuity (BCVA) and central macular thickness (CMT) during a 6-month follow-up period were compared. Results BCVA showed significant improvement in two groups at 6 months. In addition, CMT showed significant decrease in two groups at 6 months. No significant differences in the change of BCVA and CMT at 6 months after injection (P = 0.973, P = 0.639) were observed between the two groups. A statistically significant difference was found regarding the number of additional IVB injections (IVB group 0.96 ± 0.83; IVB/STA group 0.44 ± 0.70, P = 0.034).Conclusion Although combination therapy of IVB with a single simultaneous STA for treatment of ME secondary to BRVO did not affect the visual outcomes compared with IVB monotherapy, it had a benefit of reducing the number of additional IVB injections.

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Section: Discussionmentioning

confidence: 94%

Combination therapy of intravitreal bevacizumab with single simultaneous posterior subtenon triamcinolone acetonide for macular edema due to branch retinal vein occlusion

Moon

Kim

Sagong

2016

Eye

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“…28,29 It has been reported that dexamethasone has a higher melanin-binding affinity than triamcinolone 10 although dexamethasone has a much shorter ocular half-life than TA. 15,29 In addition, it is interesting to note in our study that more TA was transported into the receiving chamber when using the TA suspension instead of the saturated TA solution in the donor chamber regardless to the pigment or albino sclera-choroidal complex used. This suggests that direct contact between a TA crystal and sclera may have a more efficient trans-scleral movement than a real TA solution does.…”

Section: Figmentioning

confidence: 82%

“…We and others have demonstrated that a single subtenon TA injection can provide a long therapeutic drug level in the choroid, retina, and vitreous. [11][12][13][14][15] We found that the TA concentration in the choroid was 152 times higher than that in the vitreous following a single subtenon injection of 40 mg. 14 We hypothesized that TA might have been bound to the ocular pigment in the choroid. A recent publication by Thakur et al showed that 6 corticosteroids, including TA, all have the ability to bind to natural melanin.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Ocular Pigmentation on Transscleral Delivery of Triamcinolone Acetonide

Sun

et al. 2013

Journal of Ocular Pharmacology and Therapeutics

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Purpose: To determine the capacity and kinetics of the binding between triamcinolone acetonide (TA) and the ocular pigment for a better understanding of the transscleral delivery. Methods: In the in vitro study, natural melanin (sepia officinalis, Sigma-Aldrich) was incubated at 37°C with different concentrations of TA and the binding capacity/binding affinity was measured. The TA releasing profile from the melanin was also studied through repeated incubation of TA-melanin in fresh phosphate-buffed saline. In the ex vivo study, the effect of the choroidal pigment on the trans sclera/choroid permeability of TA was investigated through Franz-type vertical diffusion cells using both a TA suspension and a saturated TA solution.Results: The amount of TA bound to melanin increases with the increase of the TA concentration and with an increase in the incubation time. A Scatchard analysis revealed that the maximum number of moles of TA bound to melanin is predicted to be 22.43 nmol/mg, with a binding affinity of K = 2.4 · 10 -5 nM -1 . TA released from a pigment showed a fast phase within the first 24 h and a slow phase thereafter. About 40% of the bound TA released in the first day and 73.94% of accumulative release was observed after 5 days. The TA suspension showed more TA penetration through the scleral-choroid complex than the saturated solution (P = 0.0104). The apparent permeability coefficients for the suspension across the sclera-choroid of pigmented and albino rabbits are 7.48 -1.53 · 10 -6 cm/s and 10.78 -2.49 · 10 -6 cm/s, respectively. Conclusions: TA can bind to and release from the ocular pigment, which may extend the TA ocular half-life and therapeutic duration when TA is delivered through a subtenon injection. A further in vivo study is warranted to validate the findings and to quantitate the magnitude of the difference between pigmented and albino animals.

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“…Development of a safer ocular drug delivery route has become an unmet need. Our group has been focusing on periscleral drug delivery which includes transscleral [15][16][17][18][19] and suprachoroidal routes. The current study was designed to compare traditional subtenon drug delivery with the emerging technique of suprachoroidal drug delivery in the context of medical care of posterior segment eye diseases.…”

Section: Methodsmentioning

confidence: 99%

Safety and pharmacodynamics of suprachoroidal injection of triamcinolone acetonide as a controlled ocular drug release model

Chen

Liu

et al. 2015

Journal of Controlled Release

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Intraocular and Systemic Pharmacokinetics of Triamcinolone Acetonide after a Single 40-mg Posterior Subtenon Application

Cited by 55 publications

References 36 publications

Combination therapy of intravitreal bevacizumab with single simultaneous posterior subtenon triamcinolone acetonide for macular edema due to branch retinal vein occlusion

Combination therapy of intravitreal bevacizumab with single simultaneous posterior subtenon triamcinolone acetonide for macular edema due to branch retinal vein occlusion

The Effect of Ocular Pigmentation on Transscleral Delivery of Triamcinolone Acetonide

Safety and pharmacodynamics of suprachoroidal injection of triamcinolone acetonide as a controlled ocular drug release model

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