Long-term outcomes of administration of intravitreal triamcinolone acetonide after posterior vitreous detachment during pars plana vitrectomy for proliferative diabetic retinopathy

Liao, Mengyu; Huang, Yiqin; Wang, Jiaxing; Meng, Xiangda; Liu, Yuanyuan; Jin, Yu; Yan, Hua

doi:10.1136/bjophthalmol-2021-320332

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…Triamcinolone acetonide (TA) is a water-soluble glucocorticoid antibacterial drug, which is characterized by high efficiency and long-acting properties, and binding to receptors can inhibit the release of inflammatory mediators, slow down neovascularization, and reduce vascular permeability, while it can improve lysosomal membrane stability, block cells from participating in inflammatory responses, and repair inflammatory tissue damage, and is currently the most effective steroid drug for the treatment of PDR. Clinical trials have shown that intravitreal injection of TA after vitrectomy for PDR can improve postoperative visual outcomes ( 90 , 91 ). A clinical trial showed that TA combined with aminoguanidine inhibits inflammation and oxidative stress, improves vascular endothelial function and retinal function, and reduces VEGF expression in patients with DR ( 92 ).…”

Section: Treatment Of Drmentioning

confidence: 99%

Recent advances in the treatment and delivery system of diabetic retinopathy

Wang,

Zhang,

Lin

et al. 2024

Front. Endocrinol.

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Diabetic retinopathy (DR) is a highly tissue-specific neurovascular complication of type 1 and type 2 diabetes mellitus and is among the leading causes of blindness worldwide. Pathophysiological changes in DR encompass neurodegeneration, inflammation, and oxidative stress. Current treatments for DR, including anti-vascular endothelial growth factor, steroids, laser photocoagulation, and vitrectomy have limitations and adverse reactions, necessitating the exploration of novel treatment strategies. This review aims to summarize the current pathophysiology, therapeutic approaches, and available drug-delivery methods for treating DR, and discuss their respective development potentials. Recent research indicates the efficacy of novel receptor inhibitors and agonists, such as aldose reductase inhibitors, angiotensin-converting enzyme inhibitors, peroxisome proliferator-activated receptor alpha agonists, and novel drugs in delaying DR. Furthermore, with continuous advancements in nanotechnology, a new form of drug delivery has been developed that can address certain limitations of clinical drug therapy, such as low solubility and poor penetration. This review serves as a theoretical foundation for future research on DR treatment. While highlighting promising therapeutic targets, it underscores the need for continuous exploration to enhance our understanding of DR pathogenesis. The limitations of current treatments and the potential for future advancements emphasize the importance of ongoing research in this field.

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Section: Treatment Of Drmentioning

confidence: 99%

Recent advances in the treatment and delivery system of diabetic retinopathy

Wang,

Zhang,

Lin

et al. 2024

Front. Endocrinol.

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“…We supposed that VA was a potential tamponade to prevent RVH. Besides, early studies indicated that triamcinolone acetonide (TA) had potential roles on preventing RVH [14][15] after PPV and introcular proliferation [16]. We conducted this pilot prospective, observational study to observe the RVH rate, vision improvement, IOP and the side effects to see whether application of VA or TA at the end of vitrectomy for PDR with non-clearing VH is helpful for decreasing the rate of RVH, and compared between them to see which way is better.…”

Section: Introductionmentioning

confidence: 99%

Application of viscoelastic agent or triamcinolone acetonide to prevent recurrent vitreous hemorrhage after vitrectomy for proliferative diabetic retinopathy with unabsorbed vitreous hemorrhage. A pilot study

Qiu¹,

Shi²,

Zhao³

et al. 2022

Preprint

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Background: To evaluate the possibilty of preventing recurrent vitreous hemorrhage (RVH) after vitrectomy in proliferative diabetic retinopathy (PDR) patients with unabsorbed vitreous hemorrhage (VH) by intravitreal injection of viscoelastic agent (VA) at the end of the surgery and compared its effect with triamcinolone acetonide (TA).Methods: This was a pilot prospective, observational study. PDR patients with VH who underwent vitrectomy were assigned to 3 groups according to the tamponade applicated at the end of the surgery, including VA group (intravitreal injected 1ml VA if the retina was prone to bleed during the operation), TA group (intravitreal injected 2mg TA when there was much exudates), or balanced salt solution (BSS) group (no tamponade). Then posteroperative follow-up was performed routinely until 6 months after surgery. The primary outcome was the incidence of RVH, secondary outcome were the best-corrected visual acuity (BCVA) and introcular pressure (IOP). Cataract formation and other complication were also assessed.Results: A total of 68 eyes, from 68 patients, were included. 18,18,32 eyes were enrolled in the VA group, TA group and BSS group, respectively. The integral incidence of RVH after PPV was 5.6%, 5.6% and 12.5% respectively (P= 0.602). There was no early RVH in VA or TA group, wheras 3 early RVHs was identified in BSS group, however there was no significant difference (P= 0.171). Every group had one late RVH case. In all groups, final BCVA showed significant improvement compared to baseline. BCVA at any postoperative visit showed no significant differences among 3 groups. Mean IOP was higher 1 week after surgey in VA group compared with the other groups; however, in other times the differences were not significant. No cataract formation and other complication was noted in 3 groups. Conclusion: Intravitreal injection of VA or TA at the end of vitrectomy for PDR patients with unabsorbed VH tend to reduce the incidence of early RVH after vitrectomy similarly. As VA was preferred to applicate in the eyes that were prone to bleed, intravitreal injection of VA at the end of vitrectomy might be a promising method for preventing RVH in PDR patients.

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A pilot study of viscoelastic agent to prevent recurrent vitreous hemorrhage after vitrectomy for proliferative diabetic retinopathy

Qiu¹,

Shi²,

Zhao³

et al. 2022

BMC Ophthalmol

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Background To evaluate the possibilty of preventing recurrent vitreous hemorrhage (RVH) after vitrectomy in proliferative diabetic retinopathy (PDR) patients with unabsorbed vitreous hemorrhage (VH) by intravitreal injection of viscoelastic agent (VA) at the end of the surgery and compared its effect with triamcinolone acetonide (TA). Methods This was a pilot prospective, observational study. PDR patients with VH who underwent vitrectomy were assigned to 3 groups according to the tamponade applicated at the end of the surgery, including VA group (intravitreally injected 1 ml VA if the retina was prone to bleed during the operation), TA group (intravitreally injected 2 mg TA when there was much exudates), or balanced salt solution (BSS) group (no tamponade). Then postoperative follow-up was performed routinely until 6 months after surgery. The primary outcome was the incidence of RVH, secondary outcome were the best-corrected visual acuity (BCVA) and introcular pressure (IOP). Cataract formation and other complication were also assessed. Results A total of 68 eyes, from 68 patients, were included. 18,18,32 eyes were enrolled in the VA group, TA group and BSS group, respectively. The integral incidence of RVH after vitrectomy was 5.6%, 5.6% and 12.5% respectively (P = 0.602). There was no early RVH in VA or TA group, whereas 3 early RVHs were identified in BSS group, however there was no significant difference (P = 0.171). Every group had one late RVH case. In all groups, final BCVA showed significant improvement compared to baseline. BCVA at any postoperative visit showed no significant differences among 3 groups. Mean IOP was higher 1 week after surgery in VA group compared with the other groups; however, in other times the differences were not significant. No cataract formation and other complication was noted in 3 groups. Conclusion Intravitreal injection of VA or TA at the end of vitrectomy for PDR patients with unabsorbed VH tend to reduce the incidence of early RVH after vitrectomy similarly. As VA was preferred to applicate in the eyes that were prone to bleed, intravitreal injection of VA at the end of vitrectomy might be a promising method for preventing RVH in PDR patients.

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Long-term outcomes of administration of intravitreal triamcinolone acetonide after posterior vitreous detachment during pars plana vitrectomy for proliferative diabetic retinopathy

Cited by 3 publications

References 20 publications

Recent advances in the treatment and delivery system of diabetic retinopathy

Recent advances in the treatment and delivery system of diabetic retinopathy

Application of viscoelastic agent or triamcinolone acetonide to prevent recurrent vitreous hemorrhage after vitrectomy for proliferative diabetic retinopathy with unabsorbed vitreous hemorrhage. A pilot study

A pilot study of viscoelastic agent to prevent recurrent vitreous hemorrhage after vitrectomy for proliferative diabetic retinopathy

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