Difference in Clearance of Intravitreal Triamcinolone Acetonide Between Vitrectomized and Nonvitrectomized Eyes

Chin, Hee Seung; Park, Taesung; Moon, Yeon-Sung; Oh, Jung-Hyub

doi:10.1097/00006982-200507000-00002

Cited by 219 publications

(146 citation statements)

References 18 publications

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“…16 Managing ME secondary to uveitis may be particularly challenging in eyes that have undergone prior PPV surgery because intravitreal therapies that are solutions or suspensions appear to have significantly shorter half-lives in these patients, thus requiring more frequent injections. 17 DEX-intravitreal implant is a biodegradable intravitreal implant developed to provide sustained release of 700 μg of preservative-free DEX that was injected in 20 PPV eyes and in 22 non-PPV eyes in our study. Our results suggest that in terms of improvement of BCVA and decrease in CRT, DEXintravitreal implant effect is similar in both groups for the treatment of uveitic ME.…”

Section: Discussionmentioning

confidence: 99%

Long-term evaluation of dexamethasone intravitreal implant in vitrectomized and non-vitrectomized eyes with macular edema secondary to non-infectious uveitis

Pelegrín

Maza

Molins

et al. 2015

Eye

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Purpose To compare dexamethasone (DEX) intravitreal implant effect in nonvitrectomized (non-PPV) vs vitrectomized (PPV) eyes with macular edema (ME) secondary to non-infectious uveitis. Methods Medical records of patients with uveitic ME treated with DEX-intravitreal implant were reviewed. Main outcome measures were changes in central retinal thickness (CRT), best corrected visual acuity (BCVA), intraocular pressure (IOP), vitreous haze and adverse events. Statistical analysis was performed by Longitudinal Linear model using the General Estimating Equation methodology. Results Forty-two eyes of 32 patients were included. Median follow-up time was 18 months (interquartile range (IQR): 12-24). Median CRT showed its maximum decrease at the first month in non-PPV and PPV eyes without statistically significant differences between both groups (P = NS). Median Snellen BCVA, converted to logarithm (LogMAR), showed its maximum improvement at third month in both groups without statistically significant differences between them (P = NS). Median IOP was higher in non-PPV eyes than in PPV eyes from third (P = 0.025) to 12th month (P = 0.013). Vitreous haze score improved in both groups since first month and showed no differences (P = 0.706). Reinjection was performed in 45.2% of eyes at a median time of 5 months IQR: (5-6). Ocular hypertension (47.6%) was the most common adverse event.Conclusions DEX-intravitreal implant for uveitic ME has similar long-term safety profile and good response measured in terms of CRT decrease, BCVA, and vitreous haze improvement in both groups. Non-PPV eyes following DEX-intravitreal implant showed higher IOP increase than PPV eyes, showing the need for close IOP monitoring.

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Section: Discussionmentioning

confidence: 99%

Long-term evaluation of dexamethasone intravitreal implant in vitrectomized and non-vitrectomized eyes with macular edema secondary to non-infectious uveitis

Pelegrín

Maza

Molins

et al. 2015

Eye

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“…Furthermore, removal of the vitreous sump can reduce the length of time intravitreal pharmacological agents remain within the eye, making ongoing management of DMO more difficult [Chin et al 2005].…”

Section: Vitrectomymentioning

confidence: 99%

Perspective on the role of Ozurdex (dexamethasone intravitreal implant) in the management of diabetic macular oedema

Mehta

Gillies

Fraser‐Bell

2015

Therapeutic Advances in Chronic Disease

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Diabetic macular oedema (DMO) is the most common cause of visual loss in the working age population. Intravitreal therapy has superseded macular laser as the firstline treatment for the management of centre-involving DMO in most patients. As well as the proven efficacy of intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents, phase II and III clinical trials of Ozurdex intravitreal dexamethasone implants for DMO have also demonstrated a mean increase in visual acuity and corresponding mean reduction in central macular thickness, particularly in pseudophakic eyes. Because of the risk of visual loss from cataract, glaucoma and intraocular infection with the use of intravitreal steroids, Ozurdex tends to be reserved for use in patients unresponsive to anti-VEGF therapy for centre-involving DMO. Situations where Ozurdex may be considered a first-line treatment option for eyes with centre-involving DMO include pseudophakia, impending cataract surgery, or in the context of a recent arterial thromboembolic event. Because of their stable pharmacokinetics, Ozurdex slow-release implants may also be considered in vitrectomized eyes.

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“…TA is a water insoluble drug, can remain for a longer duration in the vitreous cavity and may have longer action following intravitreal administration compared to other steroids that disappear with a few days (27). Moreover, TA has been considered a comparatively safe and effective drug in treatment of ocular diseases such as uveitis, macular edema secondary to retinal vascular disease, and neovascularization i.e., CNV in age-related macular degeneration (AMD) and vitreoretinopathy (28 (Table I).…”

Section: Triamcinonlone Acetonide In Ocular Therapymentioning

confidence: 99%

“…versus nonvitrectomized) (27,48,49). The intravitreally injected drug is rapidly eliminated by the eye's natural circulatory process so that frequent injections may be required which are unpopular with many patients.…”

Section: Triamcinonlone Acetonide In Ocular Therapymentioning

confidence: 99%

Intraocular Sustained-Release Delivery Systems for Triamcinolone Acetonide

2009

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Abstract. Recently, the use of triamcinolone acetonide (TA) injection has increased dramatically in treatment for several ocular diseases. Among them, macular diseases such as macular edema due to diabetic retinopathy, venous occlusive diseases, ocular inflammation and age-related macular degeneration (AMD) are very common vision threatening disorders and are great challenges to treat. In these types of chronic retinal diseases, repeated intraocular injections of TA are often required which increases the likelihood of complications. In order to achieve sustained-release, maintain therapeutic levels of TA over longer times and reduce frequency of intravitreal injections, researchers are investigating different implantable devices or injectable systems. However, as of yet, there is no sustained-release product for TA available on the commercial market. This review discusses and compares different sustained-release devices or injectable systems that are currently being developed.

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Difference in Clearance of Intravitreal Triamcinolone Acetonide Between Vitrectomized and Nonvitrectomized Eyes

Cited by 219 publications

References 18 publications

Long-term evaluation of dexamethasone intravitreal implant in vitrectomized and non-vitrectomized eyes with macular edema secondary to non-infectious uveitis

Long-term evaluation of dexamethasone intravitreal implant in vitrectomized and non-vitrectomized eyes with macular edema secondary to non-infectious uveitis

Perspective on the role of Ozurdex (dexamethasone intravitreal implant) in the management of diabetic macular oedema

Intraocular Sustained-Release Delivery Systems for Triamcinolone Acetonide

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