Midterm Results of Low-Dose Intravitreal Triamcinolone as Adjunctive Treatment for Proliferative Vitreoretinopathy

Chen, Weiqi; Chen, Haoyu; Hou, Ping; Fok, Andrew; Hu, Yijun; Lam, Dennis Shun Chiu

doi:10.1097/iae.0b013e3181fe5427

Cited by 44 publications

(25 citation statements)

References 28 publications

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“…10–13 There are also reports that suggest a potential benefit for intravitreal steroids in retinal neovascularization 14–17 and proliferative vitreoretinopathy. 18,19 The benefit of corticosteroid injections in ADNIV is limited however, because the condition causes chronic active inflammation.…”

Section: Introductionmentioning

confidence: 99%

Inhibition of Neovascularization but Not Fibrosis With the Fluocinolone Acetonide Implant in Autosomal Dominant Neovascular Inflammatory Vitreoretinopathy

Tlucek¹,

Folk²,

Orien³

et al. 2012

Arch Ophthalmol

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Objective To review the effect of the fluocinolone acetonide implant (FA) in subjects with Autosomal Dominant Neovascular Inflammatory Vitreoretinopathy (ADNIV), an inherited, autoimmune uveitis. Methods A retrospective case series was assembled from ADNIV patients who underwent fluocinolone acetonide implantation. Visual acuity and features of ADNIV, including inflammatory cells, neovascularization, fibrosis, and cystoid macular edema were reviewed. Results Nine eyes of five related ADNIV patients with uncontrolled inflammation were reviewed. Follow-up ranged 21.7–56.7 months. Vision at implantation ranged from 20/40 to hand motion. Preoperatively, eight eyes demonstrated vitreous cell (an eighth had a diffuse vitreous hemorrhage). Eight eyes demonstrated cystoid macular edema, seven had an epiretinal membrane, and three manifested retinal neovascularization. Following implantation, vitreous cells resolved in all eyes and neovascularization regressed or failed to develop. Central macular thickness improved in four eyes. During the postoperative course, however, visual acuity continued to deteriorate, with vision at the most recent examination ranging from 20/60 to no light perception. There was also progressive intraocular fibrosis and phthisis in one case. Four eyes underwent cataract surgery. Six of the seven eyes without previous glaucoma surgery demonstrated elevated intraocular pressure at some point, and three of these required glaucoma surgery. Conclusions FA implantation may inhibit specific features of ADNIV such as inflammatory cells and neovascularization, but does not stabilize long-term vision, retinal thickening, or fibrosis. All eyes in this series required cataract extraction, and more than half required surgical intervention for glaucoma. Further studies may identify additional therapies and any benefit of earlier implantation.

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Section: Introductionmentioning

confidence: 99%

Inhibition of Neovascularization but Not Fibrosis With the Fluocinolone Acetonide Implant in Autosomal Dominant Neovascular Inflammatory Vitreoretinopathy

Tlucek¹,

Folk²,

Orien³

et al. 2012

Arch Ophthalmol

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“…The clinical evidence indicates that low-dose intravitreal TA injections as an adjunct to vitrectomy and silicone oil tamponade for PVR are effective and safe 13. Jonas et al15 found that intravitreal injections of crystalline cortisone could reduce postoperative intraocular inflammation without toxicity to the intraocular structures.…”

Section: Discussionmentioning

confidence: 99%

“…Daunomycin inhibits formation of PVR in pigmented rabbits10 and proliferation of human retinal cells 11,12. In some hospitals, steroids, including prednisone, dexamethasone, and triamcinolone acetonide (TA), are regularly used during RRD surgery to reduce the risk of PVR 13–16…”

Section: Introductionmentioning

confidence: 99%

Steroids as an adjunct for reducing the incidence of proliferative vitreoretinopathy after rhegmatogenous retinal detachment surgery: a systematic review and meta-analysis

Shi¹,

Guo²,

Liu³

et al. 2015

DDDT

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BackgroundThis meta-analysis was performed to determine the effectiveness of steroids as an adjunct following rhegmatogenous retinal detachment (RRD) surgery.MethodsRRD patients with or without proliferative vitreoretinopathy (PVR) were included. The treatment group included patients in whom steroids were used as an adjunct and a control group in which placebo was used. Only randomized controlled trials were included. We searched the main electronic databases and included studies published until July 2014. PVR odds ratio, visual acuity, retinal reattachment rate, and complications were evaluated in three trials.ResultsThree randomized controlled trials were included in the meta-analysis. There was no significant difference in the incidence of postoperative PVR between groups (heterogeneity I2=48%, P=0.14). However, the incidence of postoperative PVR was lower in the treatment group (I2=0%, P<0.0001) than in the control group when a PVR grade C study was excluded. There was no statistically significant difference in postoperative visual acuity between the treatment and control groups (odds ratio −0.18; 95% confidence interval −0.38, 0.02; P=0.08). The two groups had similar results for primary/final retinal reattachment and reoperation rate. There was no significant difference in postoperative intraocular pressure.ConclusionThis systematic review demonstrates that steroids may significantly reduce the incidence of postoperative PVR grade B or lower following RRD surgery.

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“…Corticosteroids [1–6] antiproliferative agents (5-fluoro-uracil and other fluoropyrimidines, taxol, doxorubicin, mycophenolate mofetil…, alone or in combination or with different delivery systems) [3–12], systemic, periocular, intraocular steroidal, and nonsteroidal anti-inflammatory agents [5, 13–16], colchicine [8], daunomycin [8], tissue plasminogen activator [17], heparin [12, 18–20], interferon-gamma [21, 22], calcium channel blockers [23], prolyl and lysyl hydroxylase inhibitors [19, 24–26], retinoic acid [27, 28], alpha-tocopherol [29–31], disintegrins [32], siRNA-PKC α [33]… are some of the useful drugs that have been used in the treatment of conditions such as proliferative vitreoretinopathy, bleb scarring after trabeculectomy, and other disorders with cell proliferation (progressive conjunctival or extraocular cicatrization).…”

Section: Introductionmentioning

confidence: 99%

In VitroVitamin K₃Effect on Conjunctival Fibroblast Migration and Proliferation

Pinilla

Izaguirre²,

Gonzalvo

et al. 2014

The Scientific World Journal

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Purpose. To evaluate the dose effect of vitamin K3 on wound healing mechanisms. Methods. Conjunctival fibroblasts were incubated for 24 hours. An artificial wound was made and the cells were incubated with fresh medium plus doses of vitamin K3 to be tested. Wound repair was monitored at 0, 18, 24, and 48 hours. Proliferation was measured in actively dividing cells by [3H]thymidine uptake. Six different groups were tested: group 1/no drugs added, group 2/ethanol 0.1%, group 3/vitamin K3 1 mg/L, group 4/vitamin K3 2 mg/L, group 5/vitamin K3 4 mg/L, and group 6/vitamin K3 6 mg/L. Each experiment was carried out in triplicate and 4 times. Results. There were no differences among groups at the initial time. In vitro wound repair was slower in groups 4, 5, and 6. There were no differences between control and ethanol groups and between control and vitamin K3 1 mg/L groups. Fibroblast mitogenic activity was statistically decreased in all vitamin K groups; statistical differences were found among vitamin K3 1 mg/mL and higher doses too. In groups 5 and 6, cellular toxicity was presented. Conclusions. Vitamin K3 is able to inhibit fibroblast proliferation. Vitamin K3 2 mg/L or higher doses inhibit wound healing repair, exhibiting cellular toxicity at 4 and 6 mg/L.

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Midterm Results of Low-Dose Intravitreal Triamcinolone as Adjunctive Treatment for Proliferative Vitreoretinopathy

Abstract: Low-dose (2 mg) triamcinolone acetonide intravitreal injection as an adjunct to vitrectomy and silicone oil tamponade in treating proliferative vitreoretinopathy (grade C or D) appears to be effective and safe.

Cited by 44 publications

References 28 publications

Inhibition of Neovascularization but Not Fibrosis With the Fluocinolone Acetonide Implant in Autosomal Dominant Neovascular Inflammatory Vitreoretinopathy

Inhibition of Neovascularization but Not Fibrosis With the Fluocinolone Acetonide Implant in Autosomal Dominant Neovascular Inflammatory Vitreoretinopathy

Steroids as an adjunct for reducing the incidence of proliferative vitreoretinopathy after rhegmatogenous retinal detachment surgery: a systematic review and meta-analysis

In VitroVitamin K₃Effect on Conjunctival Fibroblast Migration and Proliferation

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Midterm Results of Low-Dose Intravitreal Triamcinolone as Adjunctive Treatment for Proliferative Vitreoretinopathy

Abstract: Low-dose (2 mg) triamcinolone acetonide intravitreal injection as an adjunct to vitrectomy and silicone oil tamponade in treating proliferative vitreoretinopathy (grade C or D) appears to be effective and safe.

Cited by 44 publications

References 28 publications

Inhibition of Neovascularization but Not Fibrosis With the Fluocinolone Acetonide Implant in Autosomal Dominant Neovascular Inflammatory Vitreoretinopathy

Inhibition of Neovascularization but Not Fibrosis With the Fluocinolone Acetonide Implant in Autosomal Dominant Neovascular Inflammatory Vitreoretinopathy

Steroids as an adjunct for reducing the incidence of proliferative vitreoretinopathy after rhegmatogenous retinal detachment surgery: a&nbsp;systematic review and meta-analysis

In VitroVitamin K3Effect on Conjunctival Fibroblast Migration and Proliferation

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Steroids as an adjunct for reducing the incidence of proliferative vitreoretinopathy after rhegmatogenous retinal detachment surgery: a systematic review and meta-analysis

In VitroVitamin K₃Effect on Conjunctival Fibroblast Migration and Proliferation