Effects of Intravitreal Administration of Steroids on Experimental Subretinal Neovascularization in the Subhuman Primate

Spandau

Kamppeter

et al. 2006

Eye

Purpose To report on the follow-up of patients who received an intravitreal triamcinolone acetonide injection (IVTA) as treatment of exudative age-related macular degeneration.Methods The clinical interventional caseseries study included 205 patients (222 eyes) with progressive exudative age-related macular degeneration with subfoveal neovascularization who consecutively received an IVTA of about 20 mg as only therapeutic procedure and for whom follow-up was at least 3 months. Mean follow-up was 10.477.1 months (range, 3-35.7 months). Results Visual acuity improved significantly (Po0.001) from baseline (0.9070.45 logarithm of the minimum angle of resolution (LogMar)) to a mean minimum of 0.7970.42 LogMar during follow-up. In 86 (38.7%) eyes and in 55 (24.8%) eyes, best visual acuity increased by at least two and three Snellen lines, respectively. Comparing the measurements at specific postinjection examination dates showed that visual acuity measurements taken at 1, 2, and 3 months after injection were not significantly different from the baseline value. Measurements taken at 6, 9, and 12 months after the injection were significantly (Po0.001) lower than the measurements at baseline. Mean loss at 6 months was 1.473.8 Snellen lines, at 9 months, 2.574.6 lines, and at 12 months after the injection, 2.674.0 lines. Intraocular pressure increased significantly (Po0.001) during the first 6 months, and returned to baseline at 9 months after injection.Conclusions Single injection high-dosage IVTA did not show an apparent benefit at 12 months after injection in patients with neovascular age-related macular degeneration.

Section: Discussionmentioning

confidence: 40%

Follow-up after intravitreal triamcinolone acetonide for exudative age-related macular degeneration

Spandau

Kamppeter

et al. 2006

Eye

“…These clinical studies were supported by experimental studies on the effect of intravitreal cortisone on experimental subretinal neovascularization and other types of intraocular proliferation of blood vessel. [34][35][36][37]39,[42][43][44] Another recent investigation including 71 eyes with exudative agerelated macular degeneration demonstrated a significant increase in visual acuity after an intravitreal injection of 25 mg of triamcinolone acetonide. 48 The improvement in visual acuity was significant at 1 month (P ¼ 0.04) and 2 months (P ¼ 0.04) after the injection.…”

Section: Discussionmentioning

confidence: 42%

“…Consequently, other treatment modalities have been investigated, one of which is the intravitreal application of triamcinolone acetonide with its anti-oedematous and antiangiogenic effect, demonstrated in experimental investigations and clinical studies. [34][35][36][37][38][39][40][41][42][43][44][45][46][47][48] Penfold et al 38 started to inject triamcinolone acetonide intravitreally in an effort to treat exudative age-related macular degeneration medically. 40 In 1998, Challa et al 40 evaluated the safety and efficacy of intravitreal triamcinolone after a follow-up of 18 months in patients with exudative age-related macular degeneration considered unsuitable for laser photocoagulation.…”

Section: Discussionmentioning

confidence: 43%

“…It is in agreement with experimental studies on an angiostatic effect of intravitreal cortisone on experimental subretinal neovascularization and other types of intraocular blood vessel proliferation. 34,[35][36][37]39 An additional reason for the discrepancy between the study by Gillies and colleagues and the present as well as the preceding studies may be that Gillies' investigation included patients with the classic type of subfoveal neovascularization, which is associated with a worse prognosis compared to the occult type of subfoveal neovascularization.…”

Section: Discussionmentioning

confidence: 49%

See 1 more Smart Citation

Exudative age-related macular degeneration treated by intravitreal triamcinolone acetonide. A prospective comparative nonrandomized study

Degenring

Kreissig

et al. 2004

Eye

Exudative agerelated macular degeneration treated by intravitreal triamcinolone acetonide. A prospective comparative nonrandomized study JB Jonas, RF Degenring, I Kreissig, T Friedemann and I Akkoyun Abstract Purpose To report on visual outcome of patients receiving an intravitreal injection of triamcinolone acetonide as treatment of progressive exudative age-related macular degeneration. Methods The prospective comparative nonrandomized clinical interventional study included 187 consecutive patients with progressive exudative age-related macular degeneration, divided into a study group of 115 patients receiving an intravitreal injection of 25 mg triamcinolone acetonide, and a control group of 72 patients without treatment. The mean follow-up was 6.074.2 months. Results Visual acuity increased significantly (P ¼ 0.03) in the study group, and decreased significantly (P ¼ 0.01) in the control group, at 1 month and 3 months after start of the study. Between the study group and control group, the differences in change of visual acuity were significant (P ¼ 0.001). In the study group, the number of patients with an increase in visual acuity of 2 or more Snellen lines was significantly (P ¼ 0.001) larger than in the control group. Correspondingly, the number of patients with a decrease of 2 or more Snellen lines was significantly (P ¼ 0.007) smaller in the study group. In all, 43 (37.4%) patients of the study group experienced an increase in best visual acuity by 2 or more Snellen lines.Conclusions Visual acuity increased in patients with exudative age-related macular degeneration at 1 month and 3 months after an intravitreal injection of 25 mg triamcinolone acetonide.

“…[37][38][39][40] Systemic and local side effects reported so far include cataract, secondary ocular hypertension, leading in some patients to secondary chronic open-angle glaucoma, [41][42][43] and postinjection infectious endophthalmitis. [44][45][46] Due to its antioedematous and antiangiogenic effects as shown in experimental investigations and clinical studies, [47][48][49][50][51] intravitreal triamcinolone acetonide has additionally been used in previous pilot studies on central retinal vein occlusions. It was the purpose of the present study to evaluate whether intravitreal triamcinolone acetonide may be therapeutically useful to increase visual acuity in patients with long-standing cystoid macular oedema due to branch retinal vein occlusion.…”

Section: Introductionmentioning

confidence: 39%

Branch retinal vein occlusion treated by intravitreal triamcinolone acetonide

Akkoyun

Kamppeter

et al. 2004

Eye

147

Purpose To evaluate the effect of intravitreal triamcinolone acetonide on visual acuity in branch retinal vein occlusion. Methods The prospective comparative nonrandomized clinical interventional study included 28 patients (28 eyes) with branch retinal vein occlusion. The study group consisting of 10 consecutive patients received an intravitreal injection of 20-25 mg of triamcinolone acetonide. The control group including 18 patients did not receive an intravitreal injection. The mean follow-up was 8.774.4 months.