Intravitreal triamcinolone for macular detachment following panretinal photocoagulation

Gharbiya, Magda; Grandinetti, Felice; Gabrieli, C. Balacco

doi:10.1038/sj.eye.6701658

Cited by 11 publications

(10 citation statements)

References 6 publications

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“…The authors concluded that IVTA is a promising treatment for patients with diabetic macular oedema refractory to laser treatment. Similar results were reported in studies performed by Micelli et al (2004), Karacorlu et al (2004a), Lee & Yang (2004), Gharbiya et al (2004), and Negi et al (2004). Ozkiris et al (2004b) investigated the efficacy of intravitreal triamcinolone by evaluation of the pattern electroretinogram.…”

Section: Diffuse Diabetic Macular Oedema and Proliferative Diabetic Rsupporting

confidence: 89%

Intravitreal triamcinolone acetonide for treatment of intraocular oedematous and neovascular diseases

Jonas

2005

Acta Ophthalmologica Scandinavica

132

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ABSTRACT.Intravitreal triamcinolone acetonide (IVTA) has increasingly been applied as treatment for various intraocular neovascular and oedematous diseases. Comparing the various diseases with respect to effect and side-effects of the treatment, the best response in terms of gain in visual acuity (VA) has been achieved for intraretinal oedematous diseases such as diffuse diabetic macular oedema, branch retinal vein occlusion, central retinal vein occlusion and pseudophakic cystoid macular oedema. In eyes with various types of non-infectious uveitis, including acute or chronic sympathetic ophthalmia and Adamantiadis-Behcet's disease, VA increased and the degree of intraocular inflammation decreased. Some studies have suggested that intravitreal triamcinolone may be useful as angiostatic therapy in eyes with iris neovascularization and proliferative ischaemic retinopathies. Intravitreal triamcinolone may possibly be helpful as adjunct therapy for exudative age-related macular degeneration (AMD), particularly in combination with photodynamic therapy. In eyes with chronic, therapy-resistant ocular hypotony, intravitreal triamcinolone can induce an increase in intraocular pressure (IOP) and may stabilize the eye. The complications of intravitreal triamcinolone therapy include: secondary ocular hypertension in about 40% of the eyes injected; medically uncontrollable high IOP leading to antiglaucomatous surgery in about 1-2% of the eyes; posterior subcapsular cataract and nuclear cataract leading to cataract surgery in about 15-20% of elderly patients within 1 year of injection; postoperative infectious endophthalmitis occurring at a rate of about one per 1000; non-infectious endophthalmitis, perhaps due to a reaction to the solvent agent, and pseudo-endophthalmitis with triamcinolone acetonide crystals appearing in the anterior chamber. Intravitreal triamcinolone injection can be combined with other intraocular surgeries, including cataract surgery, particularly in eyes with iris neovascularization. Cataract surgery performed some months after the injection does not show a markedly elevated complication rate. The injection may be repeated if the resultant benefits decrease after the initial IVTA injection. In non-vitrectomized eyes, the duration of the effect and side-effects of a single intravitreal injection of triamcinolone is about 6-9 months for a dosage of about 20 mg, and about 2-4 months for a dosage of 4 mg. So far, it has remained unclear whether the solvent agent should be removed, and if so, how.

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Section: Diffuse Diabetic Macular Oedema and Proliferative Diabetic Rsupporting

confidence: 89%

Intravitreal triamcinolone acetonide for treatment of intraocular oedematous and neovascular diseases

Jonas

2005

Acta Ophthalmologica Scandinavica

132

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“…A progressive reduction in the number and size of the hard exudates was noted after intravitreal TA in all patients. Similar results were reported in studies performed by Micelli et al [32], Karaçorlu et al [28], Lee and Yang [30], Gharbiya et al [196] and Negi et al [45]. …”

Section: Clinical Studies: Ta As Drug Treatment For Macular Edemasupporting

confidence: 81%

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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“…The authors concluded that intravitreal triamcinolone acetonide is a promising treatment for patients with diabetic macular edema refractory to laser treatment. Similar results were reported in studies performed by Micelli Ferrari et al [33] , Karacorlu et al [29] , Lee and Yang [31] , Gharbiya et al [181] , and Negi et al [46] . Ozkiris et al [39] investigated the efficacy of intravitreal triamcinolone by evaluation of the pattern electroretinogram.…”

Section: Diabetic Macular Edema and Proliferative Diabetic Retinopathsupporting

confidence: 80%

Intravitreal Triamcinolone Acetonide: A Change in a Paradigm

Jonas¹

2006

Ophthalmic Res

151

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Background: Based on experimental studies and clinical observations by Robert Machemer, Gholam Peyman and others, the vitreous cavity has increasingly been used as a reservoir of drugs for the direct treatment of intraocular diseases. Methods and Results: The most widely injected drug so far has been triamcinolone acetonide for various intraocular neovascular and edematous diseases. Comparing the various diseases with respect to effect and side effects of the treatment, the best response in terms of gain in visual acuity has been achieved for intraretinal edematous diseases such as diffuse diabetic macular edema, branch retinal vein occlusion, central retinal vein occlusion, and pseudophakic cystoid macular edema. In eyes with various types of noninfectious uveitis including acute or chronic sympathetic ophthalmia and Adamantiadis-Behçet’s disease, visual acuity increased and the degree of intraocular inflammation decreased. Some studies have suggested that intra- vitreal triamcinolone may be useful as an angiostatic agent in eyes with iris neovascularization and proliferative ischemic retinopathies. Intravitreal triamcinolone may possibly be helpful as adjunct therapy for exudative age-related macular degeneration, particularly in combination with photodynamic therapy. In eyes with chronic, therapy-resistant ocular hypotony, intravitreal triamcinolone can induce an increase in intraocular pressure and may stabilize the eye. The complications of intravitreal triamcinolone therapy include secondary ocular hypertension in about 40% of the eyes injected; medically uncontrollable high intraocular pressure leading to antiglaucomatous surgery in about 1–2% of the eyes; posterior subcapsular cataract and nuclear cataract leading to cataract surgery in about 15–20% in elderly patients within 1 year after injection; postoperative infectious endophthalmitis with a rate of about 1:1,000; noninfectious endophthalmitis, perhaps due to a reaction to the solvent agent, and pseudoendophthalmitis with triamcinolone acetonide crystals appearing in the anterior chamber. Intravitreal triamcinolone injection can be combined with other types of intraocular surgery including cataract surgery, particularly in eyes with iris neovascularization. Cataract surgery performed some months after the injection does not show a markedly elevated complication rate. The injection may be repeated, if vision redecreases. In nonvitrectomized eyes, the duration of the effect and side effects of a single intravitreal injection of triamcinolone is about 6–9 months for a dosage of about 20 mg, and about 2–4 months for a dosage of 4 mg. It has remained unclear so far, whether and how to remove the solvent agent. In the future, intravitreal triamcinolone may be combined with other antiangiogenic drugs for the treatment of exudative age-related macular degeneration or with neuroprotective drugs for treatment of diabetic retinopathy. Conclusions: Despite an exponentially increasing number of mostly case-series studies, the intravitreal injection of triamcinolo...

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Intravitreal triamcinolone for macular detachment following panretinal photocoagulation

Cited by 11 publications

References 6 publications

Intravitreal triamcinolone acetonide for treatment of intraocular oedematous and neovascular diseases

Intravitreal triamcinolone acetonide for treatment of intraocular oedematous and neovascular diseases

Intravitreal Triamcinolone

Intravitreal Triamcinolone Acetonide: A Change in a Paradigm

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