Intravitreal Triamcinolone Acetonide for Diabetic Macular Edema: A Prospective, Randomized Study

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

doi:10.1089/jop.2006.22.200

Cited by 102 publications

(60 citation statements)

References 51 publications

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“…Many clinical trials have been conducted to evaluate the efficacy of IVTA therapy for DME [18][19][20][21][22][23][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52] . IVTA has shown significant improvements in diabetic macular edema and visual acuity in the short term and found to be transient.…”

Section: Intravitreal Triamcinolone Acetonide Injectionmentioning

confidence: 99%

Clinical trials on corticosteroids for diabetic macular edema

Dhibi

Arévalo

2013

WJD

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Diabetic macular edema (DME) is a common cause of visual impairment in diabetic patients. It is caused by an increase in the permeability of the perifoveal capillaries and a disruption of the blood retinal-barrier. The pathogenesis of DME is multifactorial. Several therapeutic modalities have been proposed for the treatment of DME. Corticosteroid treatments have emerged as an alternative therapy for persistent DME or refractory to conventional laser photocoagulation and other modalities, due to anti-inflammatory, anti-vascular endothelial growth factor and anti-proliferative effects. Many studies have demonstrated the beneficial therapeutic effect of corticosteroids with improvement to both retinal thickness and visual acuity in short-term on the treatment of DME. Peribulbar and intravitreal injections have been used to deliver steroids for DME with frequent injections due to the chronic and recurrent nature of the disease. Steroid-related side effects include elevated intraocular pressure, cataract, and injection related complications such as endophthalmitis, vitreous hemorrhage, and retinal detachment particularly with intravitreal steroid injections. In order to reduce the risks, complications and frequent dosing of intravitreal steroids, intravitreal implants have been developed recently to provide sustained release of corticosteroids and reduce repeated intravitreal injections for the management of DME.© 2013 Baishideng Publishing Group Co., Limited. All rights reserved.Key words: Corticosteroids; Diabetic macular edema; Intravitreal triamcinolone acetonide injection; Intravitreal steroid sustained-release implants; Peribulbar steroid injections; Subtenon's steroid Injections Core tip: Despite the documented ocular side effects of corticosteroids by the time being they are still considered as one of the essential effective adjunct modalities for the treatment of diabetic macular edema especially in refractory and persistent cases.

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Section: Intravitreal Triamcinolone Acetonide Injectionmentioning

confidence: 99%

Clinical trials on corticosteroids for diabetic macular edema

Dhibi

Arévalo

2013

WJD

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“…7 However, some treated eyes may be resistant to laser photocoagulation or efficient laser treatment could not be performed due to diffuse macular oedema. Therefore, the failure of laser photocoagulation in these eyes has prompted interest in other treatment modalities, such as intravitreal triamcinolone acetonide (IVTA) injection, 4,5,8,9 pars plana vitrectomy, 10,11 or treatment with protein kinase C inhibitors. 12 Retinal hypoxia is the primary cause of diabetic retinopathy, which increases expression of vascular endothelial growth factor (VEGF).…”

Section: Introductionmentioning

confidence: 99%

Intravitreal bevacizumab (Avastin) for primary treatment of diabetic macular oedema

Özkırış

2008

Eye

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“…[17][18][19][20][21] The mechanism of action is thought to be complex, but presumably is related to a variety of points of interaction, including lysomal stabilization, inhibition of ICAM and TNF pathways, and anti-VEGF effects. [4][5][6][7][8] In the largest prospective randomized trial of triamcinolone performed to date, by 4 months after administration of 4 mg triamcinolone, average visual acuity improved compared with either 1 mg intravitreal triamcinolone or focal modified ETDRS treatment photocoagulation.…”

Section: Steroidsmentioning

confidence: 99%