Suprachoroidal Injection of Triamcinolone—Review of a Novel Treatment for Macular Edema Caused by Noninfectious Uveitis

Price, Kenneth W.; Albini, Thomas A.; Yeh, Steven

doi:10.17925/usor.2020.13.2.76

Cited by 12 publications

(7 citation statements)

References 28 publications

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“…213 Furthermore, the exposure of the lens, iris, and vitreous humor to triamcinolone acetonide was significantly decreased with minimal exposure in the aqueous humor in the suprachoroidal injection group. 213 Recently, several other studies evaluated the efficacy of suprachoroidal injection of GCs in several retinal diseases including diabetic macular edema, 168 , 169 uveitic macular edema, 170 , 214 , 215 and retinal detachment secondary to Vogt-Koyanagi Harada disease. 216 The results showed good efficacy with no significant increase in IOP.…”

Section: Clinical Science Review Of Gig/giohtmentioning

confidence: 99%

Glucocorticoid-Induced Ocular Hypertension and Glaucoma

Harvey,

Sugali,

Mao

2024

OPTH

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Glucocorticoid (GC) therapy is indicated in many diseases, including ocular diseases. An important side-effect of GC therapy is GC-induced ocular hypertension (GIOHT), which may cause irreversible blindness known as GC-induced glaucoma (GIG). Here, we reviewed the pathological changes that contribute to GIOHT including in the trabecular meshwork and Schlemm’s canal at cellular and molecular levels. We also discussed the clinical aspects of GIOHT/GIG including disease prevalence, risk factors, the type of GCs, the route of GC administration, and management strategies.

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Section: Clinical Science Review Of Gig/giohtmentioning

confidence: 99%

Glucocorticoid-Induced Ocular Hypertension and Glaucoma

Harvey,

Sugali,

Mao

2024

OPTH

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“…Human studies assessing the safety and efficacy of suprachoroidal drug injection have been conducted for several disorders, including DME, macular edema related to retinal vein occlusion, and noninfectious uveitis [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

A combination of suprachoroidal injection of triamcinolone using a custom-made needle and intravitreal Ziv-aflibercept every eight weeks to manage naïve/denovo central DME: a single-center retrospective case series

Marashi,

Baba,

Abu Ghedda

et al. 2024

Int J Retin Vitr

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Background Previous studies have shown promising effects of combining intravitreal bevacizumab and suprachoroidal injection of triamcinolone acetonide in treating DME. However, further research is needed. Objective To assess the efficacy and safety of combining both intravitreal Ziv-aflibercept and suprachoroidal injection of triamcinolone acetonide using a custom-made needle in naïve and de novo central diabetic macular edema (DME) patients every eight weeks for 24 weeks. Methods Central macular thickness was measured via spectral domain-optical coherence tomography, and best-corrected visual acuity was measured via a Snellen chart at baseline and at 4, 8, 12, 16, and 24 weeks postinjection. Additionally, cataract progression, intraocular pressure (IOP), and ocular safety were analyzed. Results A total of 10 eyes of 6 patients were treated with suprachoroidal injections of triamcinolone acteonid combined with an intravitreal injection of Ziv-aflibercept. Vision improved from 0.69 log minimum angle of resolution (MAR) at baseline to 0.39 log MAR after treatment. Central macular thickness significantly decreased from 462.3 ± 166 μm at baseline to 362.7 ± 77.6 μm at 24 weeks postinjection. Conclusion Suprachoroidal injection of triamcinolone using a custom-made needle with the intravitreal agent Ziv-aflibercept to treat de novo/naïve central DME has favorable outcomes and adequate safety results. Moreover, this study demonstrated the benefit of adapting the previous treatment combination for extending the interval between anti-VEGF treatments from 4 to 8 weeks, which could prevent further expenses, especially in low-income countries.However, large multicenter randomized clinical trials with longer follow-up periods are needed to assess this treatment route, especially in low-income and resourced countries.

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“…[8][9][10][11] Human trials evaluating the efficacy and safety of the suprachoroidal drug delivery route have been conducted for various conditions, such as macular edema secondary to diabetes, non-infectious uveitis, and retinal vein occlusions. 12 A phase 3 trial of a suprachoroidal injection of proprietary preservative-free, terminally sterilized aqueous suspension of triamcinolone acetonide (Clearside Biomedical, Alpharetta, GA, USA) delivered with a customized system (Xipere; Clearside Biomedical) has been shown to have a high safety index in cases of non-infectious uveitis, with the incidence of IOP spike being 11.5% in patients. 13 Thus, the suprachoroidal route holds great promise in providing a therapeutic effect with a better theoretical safety profile than posterior subtenon and intravitreal routes.…”

Section: Introductionmentioning

confidence: 99%

Suprachoroidal injection of triamcinolone acetonide using a custom-made needle to treat diabetic macular edema post pars plana vitrectomy: a case series

Marashi¹,

Zazo

2022

J Int Med Res

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Objective Diabetic macular edema (DME), the most common cause of diabetes-related visual impairment, may occur following pars plana vitrectomy (PPV) to manage proliferative diabetic retinopathy complications. This retrospective single-centre case series evaluated the efficacy and safety of injecting 4 mg/0.1 ml triamcinolone into the suprachoroidal space using a custom-made needle to treat DME post PPV. Methods Data regarding central macular thickness (CMT) using spectral domain-optical coherence tomography and best-corrected visual acuity (by Snellen chart) at baseline (pre-injection), and at 1, 4, and 8 weeks following injection were analysed, along with intraocular pressure (IOP), cataract progression, and ocular safety. Results Eleven eyes in 10 patients received 11 suprachoroidal injections. Vision improvement was noted (0.75 log minimum angle of resolution (MAR) at baseline to 0.40 log MAR after treatment). CMT reduced significantly from 456.45 ± 113.42 μm at baseline to 247.63 ± 53.40 μm at 8 weeks following injection. No rise in IOP, or cataract development in the single treated phakic eye, was observed during 8 weeks of follow-up. Conclusion Suprachoroidal injection of triamcinolone using a custom-made needle to treat DME post PPV shows promising results with acceptable safety outcomes. Large clinical trials with longer follow-up are needed to evaluate this treatment option for countries with limited health-care resources.

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Suprachoroidal Injection of Triamcinolone—Review of a Novel Treatment for Macular Edema Caused by Noninfectious Uveitis

Cited by 12 publications

References 28 publications

Glucocorticoid-Induced Ocular Hypertension and Glaucoma

Glucocorticoid-Induced Ocular Hypertension and Glaucoma

A combination of suprachoroidal injection of triamcinolone using a custom-made needle and intravitreal Ziv-aflibercept every eight weeks to manage naïve/denovo central DME: a single-center retrospective case series

Suprachoroidal injection of triamcinolone acetonide using a custom-made needle to treat diabetic macular edema post pars plana vitrectomy: a case series

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