Low-dose intraocular triamcinolone injection for intractable macular oedema and inflammation in patients with uveitis

Das-Bhaumik, Raja; Jones, Nicholas P.

doi:10.1038/sj.eye.6702063

Cited by 23 publications

(14 citation statements)

References 16 publications

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“…Systemic treatment with steroids inevitably leads to secondary side effects such as systemic suppression of the whole immune system and Cushing’s syndrome. Based on the clinical experience gathered for the use of IVTA for other indications, TA has also been applied to eyes with chronic therapy-resistant uveitis [159,160,161,162,163,164,165,166,167,168,175,176,177,197,199,200,204,271,272,273,274,275]. These diseases include Adamantiadis-Behçet’s disease [199,200]: Karaçorlu et al [199] performed an intravitreal injection of TA (4 mg) in 10 eyes of 10 patients with cystoid macular edema due to Behçet’s disease.…”

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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Section: Clinical Studies: Ta In Other Ocular Diseasesmentioning

confidence: 99%

Intravitreal Triamcinolone

Tao

Jonas

2010

Ophthalmologica

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“…Das-Bhaumik and Jones showed the effi cacy of 2 mg dosing of TA in causing the resolution of CME in 80% of patients and resolution of intraocular infl ammation in only half. 47 Kok et al showed a statistically signifi cant improvement in visual acuity in patients under 60 years old treated with 4 mg of intravitreal TA. The greatest improvement in their patients was within the fi rst 4 weeks of treatment.…”

Section: Idiopathic Uveitismentioning

confidence: 97%

“…42 Several studies have been performed looking at the effi cacy of intravitreal TA in the treatment of uveitic CME. 41,43,44,45,46,47,48,49 The dose of the TA used ranged from 2 mg to 4 mg injected intravitreally. Regardless of the dose many studies showed that intravitreal TA rapidly helped macular edema and consequently visual acuity; however, in some cases this effect appeared to be transient.…”

Section: Idiopathic Uveitismentioning

confidence: 99%

“…72 Multiple studies have shown the increased incidence of elevated IOP following intravitreal TA administration. 46,47,70,73,74,75 One study comparing patients with and without uveitis treated with intravitreal TA showed the strongest risk factor for elevated IOP was the presence of uveitis. 75 One study showed that eyes with an IOP above 15 mm Hg were more likely to developed steroid responsive elevated pressure.…”

Section: Intravitreal Triamcinolonementioning

confidence: 99%

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Intravitreal triamcinolone for intraocular inflammation and associated macular edema

Couch¹

2008

OPTH

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Triamcinolone acetonide (TA) is a corticosteroid that has many uses in the treatment of ocular diseases because of its potent anti-infl ammatory and anti-permeability actions. Intraocular infl ammation broadly referred to as uveitis can result from several causes, including the immune system and after ophthalmic surgery. One of the most common reasons for vision loss with uveitis is macular edema. TA has been used for many years as an intravitreal injection for the treatment of ocular diseases. Several case control studies have been reported showing the effi cacy of TA in the treatment of intraocular infl ammation and associated macular edema caused by Behcet's disease, Vogt-Koyanagi-Harada syndrome, sympathetic ophthalmia and white dot syndromes. It has also been shown effi cacious in cases of pars planitis and idiopathic posterior uveitis. Some authors have reported its use in postoperative cystoid macular edema. Many of the studies on the use of TA in controlling intraocular infl ammation and concomitant macular edema showed its effect to be transient in many patients requiring reinjection. Complications can arise from intravitreal injection of TA including elevated intraocular pressure and cataract. Rarely, it can be associated with infectious and non-infectious endophthalmitis. TA may be useful as an adjuvant in the treatment of uveitis and its associated macular edema, especially in patients resistant or intolerant to standard treatment.

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“…In ME secondary to idiopathic uveitis, resistant to periocular and/or systemic corticosteroid treatment, 4 mg IVTA was proven to be effective in clinical and angiographic resolution of the ME for periods up to 6 months [28]. The functional response to IVTA depends on dosage and on the integrity of the macula [29]. …”

Section: Common Application Of Steroids In Mementioning

confidence: 99%

Steroids and the Management of Macular Edema

Golan

Loewenstein

2010

Ophthalmologica

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Macular edema (ME) is a condition which is usually secondary to an underlying disease process. It is most commonly seen following venous occlusive disease, diabetic retinopathy and posterior segment inflammatory disease. The treatment of ME varies, depending upon the underlying etiology, and has led to varying degrees of success. Traditionally, the main treatment options have included topical and systemic steroids, due to their known antiangiogenic, antiedematous, antiinflammatory and antiproliferative effects. This comprehensive review outlines the current use of steroids and highlights the ever-growing indications for steroids in ME secondary to various ocular conditions as well as the recent breakthrough results of the efficacy of this treatment.

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Low-dose intraocular triamcinolone injection for intractable macular oedema and inflammation in patients with uveitis

Cited by 23 publications

References 16 publications

Intravitreal Triamcinolone

Intravitreal Triamcinolone

Intravitreal triamcinolone for intraocular inflammation and associated macular edema

Steroids and the Management of Macular Edema

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