Comparison of Intravitreal versus Posterior Sub–Tenon’s Capsule Injection of Triamcinolone Acetonide for Diffuse Diabetic Macular Edema

Cardillo, J.A.; Melo, Luiz Alberto S.; Costa, Rogério A.; Skaf, M.; Belfort, Rubens; Souza–Filho, A.A.; Farah, Michel Eid; Kuppermann, Baruch D.

doi:10.1016/j.ophtha.2005.03.023

Cited by 127 publications

(70 citation statements)

References 27 publications

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“…Triamcinolone acetonide (intravitreal or sub-Tenon's administration) can provide effective short-term treatment of diabetic macular oedema. 58,59 The visual outcome after diabetic vitrectomy may sometimes be limited by the presence of new or persistent diabetic macular oedema. Laser photocoagulation is currently the standard treatment for patients with post-operative diabetic macular oedema.…”

Section: Adjunctive Pharmacotherapymentioning

confidence: 99%

Surgical management of the late complications of proliferative diabetic retinopathy

Newman

2010

Eye

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The late complications of proliferative diabetic retinopathy (PDR) comprise vitreous haemorrhage, tractional retinal detachment, combined tractional-rhegmatogenous retinal detachment, and severe fibrovascular proliferation (including macular distortion or dragging, tractional macular oedema, and media opacity due to fibrovascular tissue). This article will review the indications, techniques, and outcomes of vitrectomy surgery to treat these conditions. A careful assessment of the surgical anatomy, with particular attention to the configuration of vitreoretinal attachments, is important when determining the precise surgical procedure required. The surgical outcome after diabetic vitrectomy has steadily improved with advances in vitreoretinal surgical instrumentation and technique. Significant post-operative complications may, however, occur including cataract formation, recurrent vitreous cavity haemorrhage (early or delayed), rhegmatogenous retinal detachment, and neovascular glaucoma. Most patients will regain or retain useful vision after diabetic vitrectomy, although the visual outcome does remain unpredictable. The development of adjunctive pharmacotherapy should enable further improvements in visual outcome in the future.

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Section: Adjunctive Pharmacotherapymentioning

confidence: 99%

Surgical management of the late complications of proliferative diabetic retinopathy

Newman

2010

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“…[15][16][17]19,20 Posterior subtenon triamcinolone acetonide (STA) has the advantage of easy injection and decreased risk of intraocular complications such as IOP elevation and cataract progression compared with IVTA, but the efficacy of STA is thought be slightly less than that of IVTA. [21][22][23] Intravitreal dexamethasone implant has recently been found to be effective in reducing ME and improving visual function. In addition, its risk of complications such as glaucoma and cataract was relatively lower and its intraocular half-life was longer.…”

Section: Introductionmentioning

confidence: 99%

Combination therapy of intravitreal bevacizumab with single simultaneous posterior subtenon triamcinolone acetonide for macular edema due to branch retinal vein occlusion

Moon

Kim

Sagong

2016

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Purpose To evaluate efficacy and safety of combination therapy of intravitreal bevacizumab (IVB) with single simultaneous posterior subtenon triamcinolone acetonide (STA) for treatment of macular edema (ME) secondary to branch retinal vein occlusion (BRVO). Methods This was a prospective, randomized, interventional comparative study conducted in 45 eyes with ME secondary to BRVO who were treated primarily with IVB 1.25 mg (23 eyes, IVB group) or combination therapy of IVB 1.25 mg with a single simultaneous STA 40 mg (18 eyes, IVB/STA group). Reinjections were performed with IVB if optical coherence tomography (OCT) showed recurrent ME associated with decreased visual acuity. The main outcome measurement was the number of additional IVB injections, and changes of best-corrected visual acuity (BCVA) and central macular thickness (CMT) during a 6-month follow-up period were compared. Results BCVA showed significant improvement in two groups at 6 months. In addition, CMT showed significant decrease in two groups at 6 months. No significant differences in the change of BCVA and CMT at 6 months after injection (P = 0.973, P = 0.639) were observed between the two groups. A statistically significant difference was found regarding the number of additional IVB injections (IVB group 0.96 ± 0.83; IVB/STA group 0.44 ± 0.70, P = 0.034).Conclusion Although combination therapy of IVB with a single simultaneous STA for treatment of ME secondary to BRVO did not affect the visual outcomes compared with IVB monotherapy, it had a benefit of reducing the number of additional IVB injections.

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“…The main advantages of periocular administration of TA vs intravitreal injection were a lower risk of endophthalmitis and IOP rise although the effect in reducing macular edema is not nearly as strong as is that of intravitreal injection. 7,9 Specially, it has been reported that younger age is a risk factor for a marked IOP rise after intravitreal TA. 2 Therefore, in our clinic, we choose to administrate TA by PST delivery when patients are at a younger age (usually o45 years).…”

Section: Commentmentioning

confidence: 99%

“…[2][3][4] Posterior sub-Tenon's (PST) injection of steroid is an alternative route with proven effectiveness in resolution of cystoid macular oedema and only few patients developed IOP raised. [5][6][7] Herein, we report a young adult receiving PST injection of TA for central retinal vein occlusion (CRVO) who developed intractable glaucoma despite maximal antiglaucoma medication and surgical excision of the depot TA. He underwent trabeculectomy and IOP was well controlled rapidly after surgery.…”

mentioning

confidence: 99%

Intractable glaucoma following posterior sub-tenon's triamcinolone acetonide for central retinal vein occlusion in a young adult

et al. 2006

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Comparison of Intravitreal versus Posterior Sub–Tenon’s Capsule Injection of Triamcinolone Acetonide for Diffuse Diabetic Macular Edema

Cited by 127 publications

References 27 publications

Surgical management of the late complications of proliferative diabetic retinopathy

Surgical management of the late complications of proliferative diabetic retinopathy

Combination therapy of intravitreal bevacizumab with single simultaneous posterior subtenon triamcinolone acetonide for macular edema due to branch retinal vein occlusion

Intractable glaucoma following posterior sub-tenon's triamcinolone acetonide for central retinal vein occlusion in a young adult

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