Intravitreal triamcinolone as a primary therapy in diabetic macular oedema

Karaçorlu, Murat; Özdemir, Hakan; Karacorlu, Serra; Alacali, Nilay; Mudun, Baki; Burumcek, Engin

doi:10.1038/sj.eye.6701512

Cited by 50 publications

(42 citation statements)

References 28 publications

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“…Following Robert Machemer, Gholam Peyman, and others, [1][2][3][4][5][6] intravitreal triamcinolone acetonide has increasingly been used in recent studies as treatment for other intraocular proliferative, oedematous, and neovascular diseases, such as diffuse diabetic macular oedema, [7][8][9][10][11][12][13] central retinal vein occlusion, [14][15][16][17] branch retinal vein occlusion, [18][19][20] chronic uveitis, [21][22][23][24][25] persistent pseudophakic cystoid macular oedema, [26][27][28][29] exudative age-related macular degeneration, [30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] and other diseases. 6 It has remained unclear so far, whether the various ocular disorders differ in their response to intravitreal triamcinolone acetonide in terms of an increase in visual acuity and a rise in intraocular pressure.…”

Section: Introductionmentioning

confidence: 99%

Visual acuity and intraocular pressure after high-dose intravitreal triamcinolone acetonide in selected ocular diseases

Jonas¹,

Schlichtenbrede²

2007

Eye

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Purpose Within the last 5 years, intravitreal injections of triamcinolone acetonide have been for a wide variety of ocular diseases with intraocular oedema and neovascularization. With clinical experience accumulating, the question arises for which indication the side effects outweigh the therapeutic efficacy of intravitreal triamcinolone monotherapy. Scope Comparing different diseases, increase in visual acuity was lower in patients receiving intravitreal triamcinolone monotherapy for exudative age-related macular degeneration than in patients with diabetic macular oedema, branch retinal vein occlusion, central retinal vein occlusion, uveitis, and pseudophakic cystoid macular oedema. Rise in intraocular pressure was significantly higher in relatively young patients with uveitis than in any other patient group. Conclusions Improvement in vision after intravitreal triamcinolone monotherapy is highest in non-ischaemic diseases with an intraretinal macular oedema such as pseudophakic cystoid macular oedema; it is lower in partially ischaemic diseases with intraretinal macular oedema such as diabetic macular oedema or retinal vein occlusions; and it is lowest in diseases with a primarily subretinal location of the disease such as exudative age-related macular degeneration. For the latter diseases, intravitreal triamcinolone monotherapy is, therefore, no longer up-to-date, particularly with the upcoming intravitreal application of vascular endothelial growth factor blocking drugs. For diseases with intraretinal oedema, the rule of thumb may be that intravitreal triamcinolone increases vision as much as retinal ischaemia and tissue destruction by the underlying disease allow it. The rise in intraocular pressure is higher in relatively young patients with uveitis than in elderly patients with other reasons for macular oedema.

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Section: Introductionmentioning

confidence: 99%

Visual acuity and intraocular pressure after high-dose intravitreal triamcinolone acetonide in selected ocular diseases

Jonas¹,

Schlichtenbrede²

2007

Eye

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“…14,15 Previously, IVTA was considered as an alternative in resistant DME cases, but now some authors suggest it as a first choice treatment without combination. 16,17 Macular PC performed after IVTA was reported to provide significant VA increases at 3 rd and 6 th months, whereas some studies reported insignificant differences. [18][19][20][21] There are few studies evaluated the effects of macular PC added to IVTA on VA.…”

Section: The Effect Of Macular Laser Photocoagulation Onmentioning

confidence: 92%

“…In contrast, two previous studies reported significant VA increases during 6 months with only IVTA application. 16,17 After IVTA, foveal thickness is reduced and retinal transparency is obtained. These effects may increase the effect of macular grid laser on photoreceptors and retinal pigment epithelium which in turn reduces recurrence of DME.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Macular Laser Photocoagulation on Visual Prognosis Before and After Intravitreal Triamcinolone Acetonide Injection in Diabetic Macular Edema

Özal¹,

Esgin²

2015

Turkiye Klinikleri J Ophthalmol

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A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : To investigate the effect of macular laser photocoagulation (PC) on visual acuity (VA) before and after intravitreal triamcinolone acetonide (IVTA) injection in patients with diabetic macular edema (DME). M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : A hundred and thirty-four eyes that received single-dose IVTA 4 mg following DME diagnosis were divided into three groups: eyes with no PC (n=37), eyes that received PC before IVTA 8n=46) and eyes that received PC only after IVTA (n=51). Visual acuity values (LogMAR) were measured at start (before injection), 1. th month (p=0.001). Patients who received IVTA and then macular laser PC in the first month showed similar VA results when compared to patients who received only IVTA. During the two years follow-up, 4% of all patients developed secondary glaucoma that was controlled by medication. C Co on nc cl lu us si io on n: : In patients with DME, IVTA injection with or without macular laser PC provided significant improvement in VA of all eyes during six months. IVTA combined with macular laser PC treatment in the 1 st month did not provide an additional benefit. However, we suggest that it may be useful for reducing VA loss at the end of two years.K Ke ey y W Wo or rd ds s: : Intravitreal injections; macular edema; triamcinolone acetonide; visual acuity Ö ÖZ ZE ET T A Am ma aç ç: : Diyabetik makula ödemli (DMÖ) olgularda, vitre içi triamsinolon asetonid (İVTA) enjeksiyonundan önce veya sonra makuler lazer fotokoagülasyon (FK) yapılmasının görme keskinliği (GK) üzerine olan etkisini araştırmak. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : DMÖ tanısı ile tek doz 4 mg İVTA uygulanmış 134 göz, hiç makuler FK yapılmamış olanlar (37 göz), yalnızca İVTA öncesi makuler FK yapılmış olanlar (46 göz) ve yalnızca İVTA sonrası makuler FK yapılmış olanlar (51 göz) olmak üzere 3 gruba ayrıldı. Hastaların enjeksiyon öncesi, 1. hafta, 1. ay, 3. ay 6. ay, 1. yıl ve 2. yılda GK değer-leri (LogMAR) karşılaştırıldı. B Bu ul lg gu ul la ar r: : Öncesinde makuler FK yapılmış olan DMÖ'lü olgularda İVTA sonrası 1. hafta (p=0,008) ve 1. ay, 3. ay ve 6. ayda (p=0,001, p=0,002, p=0,001) başlangıca göre GK'de anlamlı artış saptanmıştır. DMÖ tanısı ile sadece İVTA yapılan olgularda GK 6. ayda, başlangıca göre anlamlı derecede daha iyidir (p=0,001). İVTA sonrası 1. ayda makuler lazer FK yapılan olgularla, sadece İVTA yapılan olgular arasında GK değerleri benzer olarak saptanmıştır. İki yılda olguların %4'ünde medikasyonla kontrol altına alınabilen sekonder glokom gelişmiştir. S So on nu uç ç: : DMÖ'lü olgularda, İVTA enjeksiyonu ile beraber makuler lazer FK yapılan ve yapılmayan bütün gözlerde GK'de 6 ay boyunca anlamlı artış sağlandığını saptadık ve İVTA ile kombine 1. ayda uygulanan makuler lazer tedavisinin, sadece İVTA uygulamasına göre ilk bir yıl boyunca ek bir kazanım sağlamamakla beraber, iki yıl sonunda gelişebilecek GK kaybını azaltmakta faydalı olabileceğini düşündük.A An na ah h t ta ar r K Ke e l li i m me...

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“…1 However , we would like to highlight several points that may affect the conclusions of their study.…”

mentioning

confidence: 99%

“…We are grateful for Ziahosseini and associates' comments regarding our article. 1 Various studies have shown the benefit of intravitreal triamcinolone acetonide injection in patients with macular oedema secondary to several reasons. [2][3][4][5][6] In our article, the effect of intravitreal triamcinolone in 12 eyes of 12 patients with diabetic macular oedema that had no previous laser treatment was evaluated.…”

mentioning

confidence: 99%