Intravitreal Triamcinolone Acetonide for Treatment of Central Retinal Vein Occlusion

Jonas, Jb; Akkoyun, İmren; Kamppeter, Bernd A.; Kreissig, Ingrid; Degenring, Robert F.

doi:10.1177/112067210501500615

Cited by 53 publications

(45 citation statements)

References 45 publications

(80 reference statements)

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Section: Discussionmentioning

confidence: 99%

“…6,7,[9][10][11][12][13][14][15][16][17][18][19] A disturbed balance of angiogenic and inflammatory cytokines has been reported to be associated with retinal vein occlusion, 20 and experimental investigations and clinical studies have suggested a temporary antioedematous and antiangiogenic effect of intravitreal triamcinolone in eyes with CRVO. 6,7,[9][10][11][12][13][14][15][16][17][18][19] The two major side effects of the intravitreal triamcinolone were a steroid induced increase in intraocular pressure and development of cataract. [21][22][23][24][25] In contrast, studies on intravitreal bevacizumab by Rosenfeld et al and other researchers showed an improvement in visual acuity, reduction in macular thickness, and only minor complications in patients with CRVOs, [26][27][28][29][30][31][32][33][34] so that intravitreal triamcinolone was rapidly exchanged by intravitreal bevacizumab for the treatment of CRVO.…”

Section: Discussionmentioning

confidence: 99%

“…5 In the past 8 years, a change in a paradigm has taken place, now to consider the vitreous cavity as drug reservoir for the treatment of retinal disorders, such as diabetic retinopathy and retinal vein occlusions. 6 The first drug, which was intravitreally injected was triamcinolone, [7][8][9][10][11][12][13][14] followed by ranibizumab and bevacizumab. [15][16][17][18][19][20][21][22] Both drugs differ in the spectrum of side effect and potentially in the magnitude and duration of their effect.…”

mentioning

confidence: 99%

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Intravitreal bevacizumab vs triamcinolone acetonide for macular oedema due to central retinal vein occlusion

Tao

Hou

et al. 2009

Eye

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Purpose To compare the effect of intravitreal bevacizumab vs intravitreal triamcinolone for the treatment of non-ischaemic central retinal vein occlusion (CRVO). Methods The comparative nonrandomized retrospective clinical interventional study included 72 patients with non-ischaemic CRVO, divided into a bevacizumab group of 30 patients (1.25 mg bevacizumab) and a triamcinolone group of 42 patients (4.0 mg triamcinolone). All patients were consecutively included. At baseline, both study groups did not vary significantly in visual acuity, macular thickness, and duration of symptoms (191 ± 300 days vs 222 ± 256 days). The minimal follow-up was 3 months (mean: 7.8 ± 4.3 months; range: 3-12 months). During follow-up, 1.3 ± 0.4 reinjections of the triamcinolone group (range: 1-2 injections) and 2.7±1.8 re-injections of bevacizumab (range:1-6 injections) were administered. Results In both study groups, the mean visual acuity increased significantly (Po0.001) from baseline during follow-up. The differences in gain in visual acuity were not statistically significant (P40.40) between both study groups at any time during follow-up. The mean macular thickness decreased significantly (Po0.001) in both study groups, with the reduction being significantly (P ¼ 0.006) more pronounced in the triamcinolone group. Intraocular pressure increased significantly (Po0.001) in the triamcinolone group. ConclusionsIn long-standing non-ischaemic CRVO, intravitreal bevacizumab and intravitreal triamcinolone are both associated with a comparable gain in visual acuity. The reduction in macular oedema was more marked in the triamcinolone group. In view of the potential complications of intravitreal triamcinolone in terms of intraocular pressure rise and cataractogenesis, bevacizumab may be preferred compared with triamcinolone for intravitreal use in non-ischaemic CRVO. Retinal vein occlusions belong to the most common retinal disorders affecting the macula and reducing central visual acuity. [1][2][3] In a recent populationbased study, retinal vein occlusions were detected in about 0.7% of eyes of adult Chinese aged 40 þ years. Branch retinal vein occlusions were about 12 times more common than central retinal vein occlusions (CRVOs), and the non-ischaemic type was about 9 times more common than the ischaemic type. From a pathogenic point of view, a decreased tissue perfusion and an increased hydrostatic pressure within the involved segments as a consequence of the vascular obstruction may lead to intraretinal haemorrhages, exudation of fluid, varying levels of tissue ischaemia, and eventually to intraocular neovascularization, if retinal ischaemia is pronounced. 4 Although the Central Vein Occlusion Study Group has shown the beneficial of panretinal

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Intravitreal bevacizumab vs triamcinolone acetonide for macular oedema due to central retinal vein occlusion

Tao

Hou

et al. 2009

Eye

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“…After the first reports on the use of IVTA for the treatment of CRVO by Greenberg et al [99] and Jonas et al [104], the number of reports on the use of IVTA as therapy of CRVO have increased exponentially [93,94,95,96,97,98,99,100,101,102,103,104,105,106,107,108,109,110,111]. In a prospective nonrandomized comparative study on 11 eyes with CRVO receiving an intravitreal injection of TA, compared with 6 eyes of a control group without intravitreal injection of TA, the gain in visual acuity was significantly (p = 0.003) higher in the study group [103].…”

Section: Clinical Studies: Ta As Drug Treatment For Macular Edemamentioning

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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“…They have potent anti-inflammatory effects, can reduce vascular permeability, inhibit fibrin deposition and leukocyte movement, suppress homing and migration of inflammatory cells, stabilize endothelial cell tight junctions, and inhibit synthesis of VEGF, prostaglandins, and other cytokines [18]. Intravitreal injections of the lipophilic corticosteroid triamcinolone acetonide have been shown to produce benefits in eyes with RVO, but several adverse events have been noted (with elevated intraocular pressure [IOP] and cataract being the most common) [8,10,15,[21][22][23][24][25][26][27][28][29]. Other corticosteroids, however, have their own unique properties and may have different clinical profiles in intravitreal use [30].…”

Section: Introductionmentioning

confidence: 99%

Intravitreal Dexamethasone Implant (Ozurdex) for Macular Edema Secondary to Retinal Vein Occlusion

2017

International Journal of Research Studies in Medical and Health

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Intravitreal Triamcinolone Acetonide for Treatment of Central Retinal Vein Occlusion

Abstract: Intravitreal triamcinolone acetonide temporarily increases visual acuity in central retinal vein occlusion. It is accompanied by an increase in intraocular pressure.

Cited by 53 publications

References 45 publications

Intravitreal bevacizumab vs triamcinolone acetonide for macular oedema due to central retinal vein occlusion

Intravitreal bevacizumab vs triamcinolone acetonide for macular oedema due to central retinal vein occlusion

Intravitreal Triamcinolone

Intravitreal Dexamethasone Implant (Ozurdex) for Macular Edema Secondary to Retinal Vein Occlusion

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