Intravitreal triamcinolone for diffuse diabetic macular oedema

Gibran, S K; Cullinane, Anthony; Jungkim, S.; Cleary, Philip E.

doi:10.1038/sj.eye.6701992

Cited by 20 publications

(15 citation statements)

References 19 publications

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“…Intravitreally injected triamcinolone, a corticosteroid, has been successfully used for the therapy of chronic diffuse diabetic macular edema [4,11,12,13,14,15]. Triamcinolone reduces VEGF expression, vascular leakage and inflammatory responses, all factors known to play a role in the pathogenesis of diabetic macular edema [16,17].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Intravitreal Bevacizumab versus Triamcinolone for the Treatment of Diffuse Diabetic Macular Edema

et al. 2010

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Background: Our purpose was to compare the effect of triamcinolone and bevacizumab (Avastin) on the retinal thickness and functional outcome in patients with diabetic macular edema. Methods and Materials: A collective of 32 patients, who had been treated by a single 4.0-mg intravitreal triamcinolone injection (group 1), was matched to 32 patients (‘matched pairs’), who had received 3 injections of 1.25 mg of bevacizumab within 3 months in 4-week intervals (group 2). The outcome variables were changes in best corrected visual acuity (VA) and central retinal thickness 3 months after therapy. Results: Both groups did not differ regarding preoperative VA and central retinal thickness measured by optical coherence tomography. The baseline mean VA was 0.72 ± 0.39 logMAR in group 1 and 0.73 ± 0.39 logMAR in group 2 (p = 0.709). The mean central retinal thickness measured by optical coherence tomography was 548 ± 185 µm in group 1 and 507 ± 192 µm in group 2. While the patients in group 1 experienced a slight increase in VA of on average 0.7 lines following a single triamcinolone injection to a mean of 0.64 ± 0.40 logMAR (p = 0.066) after 3 months, the patients in group 2 showed almost no effect on VA with an average increase of 0.2 lines to a mean VA of 0.72 ± 0.30 logMAR (p = 0.948) following 3 intravitreal injections of bevacizumab. Comparing the effect on VA between both groups no statistically significant difference (p = 0.115) was noted. Concerning decrease in central retinal thickness both therapies were highly effective (p < 0.001 each), again, without statistically significant difference between the groups (p < 0.128). Conclusion: Our data suggest that a single triamcinolone injection may be as effective as a 3 times repeated intravitreal administration of bevacizumab for the treatment of diabetic macular edema. Further prospective trials should be performed.

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Section: Discussionmentioning

confidence: 99%

Comparison of Intravitreal Bevacizumab versus Triamcinolone for the Treatment of Diffuse Diabetic Macular Edema

et al. 2010

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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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“…Vários autores relataram que a TA aplicada tanto via intravítrea quanto via subtenoniana pode reduzir o edema macular diabético de forma significativa (10,(15)(16)(17)(18) . Uma série com 38 portadores de EMD, demonstrou que 4 mg de IVTA foi capaz de reduzir a espessura macular basal em 33,8% no 1º mês e em 40,1% no 3º mês de seguimento (18) .…”

Section: Discussionunclassified

“…Uma série com 38 portadores de EMD, demonstrou que 4 mg de IVTA foi capaz de reduzir a espessura macular basal em 33,8% no 1º mês e em 40,1% no 3º mês de seguimento (18) . Entretanto, tanto reduções maiores (16) , de cerca de 60%, como reduções menores (10) de aproximadamente 30% já foram relatadas.…”

Section: Discussionunclassified

“…Esta melhora pode ser observada já na primeira semana pós-tratamento (20) . Entretanto, assim como acontece na espessura macular, o efeito é transitório, durando cerca de cinco a nove meses (10,16,18,20) . Na tentativa de prolongar o benefício do tratamento, alguns autores associaram o grid macular três semanas após a IVTA (13) e observaram que estes pacientes, quando comparados aos que receberam apenas IVTA, apresentaram maior ganho de visão após três e seis meses de seguimento.…”

Section: Discussionunclassified

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