Vitreous concentrations of triamcinolone acetonide in human eyes after intravitreal or subtenon injection

Inoue, Makoto; Takeda, Kayoko; Morita, Kunihiko; Yamada, Masakazu; Oguchi, Yoshihisa

doi:10.1016/j.ajo.2004.05.028

Cited by 107 publications

(60 citation statements)

References 5 publications

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“…The better efficacy of IVTA could be attributed to the higher intravitreal TA concentrations that were previously detected after intravitreal drug injection as compared to a posterior periocular injection. 20 However, in contrast to the aforementioned studies, OFTA was administered for inflammatory activity and not to treat macular oedema in our study. We observed a proportion of patients in whom visual acuity deteriorated (11%) in the course of the follow-up.…”

Section: Discussionmentioning

confidence: 66%

Orbital floor triamcinolone acetonide injections for the management of active non-infectious uveitis

Roesel

Gutfleisch

Heinz

et al. 2008

Eye

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Purpose To evaluate the effect of orbital floor triamcinolone acetonide (OFTA) injections on inflammation and visual acuity in active non-infectious uveitis. Methods Monocentre, retrospective study in 94 eyes (86 patients) with acute non-infectious uveitis receiving a single OFTA (40 mg) injection. Outcome measures were anterior chamber (AC) and vitreous cell counts, laser flare photometry, best-corrected visual acuity (BCVA), and complications over a 6-month follow-up period. Results The number of patients with X1 þ cells in AC and vitreous was significantly lower after treatment than at baseline (each, Po0.01 at the follow-up examinations). The anti-inflammatory effect lasted for the 6-month follow-up period. Laser flare photometry values were also significantly lower than the baseline levels at 3 (Po0.01) and 6 (P ¼ 0.034) months. BCVA did not differ before and after treatment. Macular oedema was reduced in 27%, unchanged in another 59%, and worse in 14%. Within 6 months, ocular hypertension was observed in up to 8% and progressing cataract was noted in 29%. Conclusions OFTA injections improved AC and vitreous inflammation, but the effect on visual acuity and macular oedema was limited.

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Section: Discussionmentioning

confidence: 66%

Orbital floor triamcinolone acetonide injections for the management of active non-infectious uveitis

Roesel

Gutfleisch

Heinz

et al. 2008

Eye

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“…Although they are not considered ideal to obtain a therapeutic dose of cortisone at the level of the retina [29,30] , short-term efficacy has been demonstrated with transient improvement to both retinal thickness and visual acuity but less effective than intravitreal therapy [16,17,30] . However, a phase Ⅱ study sponsored by the national eye institute, showed no benefit in reducing retinal thickness by adding peribulbar steroids to focal laser treatment for eyes with mild DME and good visual acuity [6,24] .…”

Section: Injectionsmentioning

confidence: 99%

Clinical trials on corticosteroids for diabetic macular edema

Dhibi

Arévalo

2013

WJD

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Diabetic macular edema (DME) is a common cause of visual impairment in diabetic patients. It is caused by an increase in the permeability of the perifoveal capillaries and a disruption of the blood retinal-barrier. The pathogenesis of DME is multifactorial. Several therapeutic modalities have been proposed for the treatment of DME. Corticosteroid treatments have emerged as an alternative therapy for persistent DME or refractory to conventional laser photocoagulation and other modalities, due to anti-inflammatory, anti-vascular endothelial growth factor and anti-proliferative effects. Many studies have demonstrated the beneficial therapeutic effect of corticosteroids with improvement to both retinal thickness and visual acuity in short-term on the treatment of DME. Peribulbar and intravitreal injections have been used to deliver steroids for DME with frequent injections due to the chronic and recurrent nature of the disease. Steroid-related side effects include elevated intraocular pressure, cataract, and injection related complications such as endophthalmitis, vitreous hemorrhage, and retinal detachment particularly with intravitreal steroid injections. In order to reduce the risks, complications and frequent dosing of intravitreal steroids, intravitreal implants have been developed recently to provide sustained release of corticosteroids and reduce repeated intravitreal injections for the management of DME.© 2013 Baishideng Publishing Group Co., Limited. All rights reserved.Key words: Corticosteroids; Diabetic macular edema; Intravitreal triamcinolone acetonide injection; Intravitreal steroid sustained-release implants; Peribulbar steroid injections; Subtenon's steroid Injections Core tip: Despite the documented ocular side effects of corticosteroids by the time being they are still considered as one of the essential effective adjunct modalities for the treatment of diabetic macular edema especially in refractory and persistent cases.

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“…Robert Machemer and colleagues in particular thought about intravitreal triamcinolone acetonide (IVTA) as a therapy of proliferative vitreoretinopathy [1,3,4,9,13,14,15,16]. As a consequence of Machemer’s suggestion, IVTA has been used for the treatment of other intraocular proliferative, edematous and neovascular diseases such as proliferative diabetic retinopathy [17,18], diffuse diabetic macular edema (DME) and diabetic retinopathy in general [18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79], branch retinal vein occlusion (BRVO) [80,81,82,83,84,85,86,87,88,89,90,91,92], central retinal vein occlusion (CRVO) […”

Section: Introductionmentioning

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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Vitreous concentrations of triamcinolone acetonide in human eyes after intravitreal or subtenon injection

Cited by 107 publications

References 5 publications

Orbital floor triamcinolone acetonide injections for the management of active non-infectious uveitis

Orbital floor triamcinolone acetonide injections for the management of active non-infectious uveitis

Clinical trials on corticosteroids for diabetic macular edema

Intravitreal Triamcinolone

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