Intravitreal Triamcinolone Prior to Laser Treatment of Diabetic Macular Edema

Gillies, Mark C; McAllister, Ian L.; Zhu, Meidong; Wong, Wan Ling; Louis, Damien; Arnold, Jennifer; Wong, Tien Yin

doi:10.1016/j.ophtha.2010.09.029

Cited by 61 publications

(49 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…26,27 In our study, VA results of IVTA group and IVTA plus PC group were similar. We suggest that IVTA and then macular laser PC in the first month after injection may reduce VA loss at the end of 2 years.…”

Section: Discussionsupporting

confidence: 65%

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

View full text Add to dashboard Cite

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...

show abstract

Section: Discussionsupporting

confidence: 65%

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

View full text Add to dashboard Cite

show abstract

“…In the subgroup analysis of patients who were pseudophakic at baseline, the triamcinolone plus laser group appeared superior to the laser alone treatment and equivalent to the treatment arms utilizing ranibizumab [60,61] . Recently, Gillies et al [62] reported the 24-mo results of a randomized controlled trial of intravitreal triamcinolone plus laser versus laser treatment only for diabetic macular edema which showed that treatment with IVTA plus macular laser resulted in a doubling of improvement in vision compared with laser only over 2 years in eyes with DME, but associated with cataract and raised intraocular pressure. …”

Section: Intravitreal Triamcinolone Acetonide Injectionmentioning

confidence: 99%

Clinical trials on corticosteroids for diabetic macular edema

Dhibi

Arévalo

2013

WJD

View full text Add to dashboard Cite

Diabetic macular edema (DME) is a common cause of visual impairment in diabetic patients. It is caused by an increase in the permeability of the perifoveal capillaries and a disruption of the blood retinal-barrier. The pathogenesis of DME is multifactorial. Several therapeutic modalities have been proposed for the treatment of DME. Corticosteroid treatments have emerged as an alternative therapy for persistent DME or refractory to conventional laser photocoagulation and other modalities, due to anti-inflammatory, anti-vascular endothelial growth factor and anti-proliferative effects. Many studies have demonstrated the beneficial therapeutic effect of corticosteroids with improvement to both retinal thickness and visual acuity in short-term on the treatment of DME. Peribulbar and intravitreal injections have been used to deliver steroids for DME with frequent injections due to the chronic and recurrent nature of the disease. Steroid-related side effects include elevated intraocular pressure, cataract, and injection related complications such as endophthalmitis, vitreous hemorrhage, and retinal detachment particularly with intravitreal steroid injections. In order to reduce the risks, complications and frequent dosing of intravitreal steroids, intravitreal implants have been developed recently to provide sustained release of corticosteroids and reduce repeated intravitreal injections for the management of DME.© 2013 Baishideng Publishing Group Co., Limited. All rights reserved.Key words: Corticosteroids; Diabetic macular edema; Intravitreal triamcinolone acetonide injection; Intravitreal steroid sustained-release implants; Peribulbar steroid injections; Subtenon's steroid Injections Core tip: Despite the documented ocular side effects of corticosteroids by the time being they are still considered as one of the essential effective adjunct modalities for the treatment of diabetic macular edema especially in refractory and persistent cases.

show abstract

“…There are known 5 isoforms of VEGF. At present, pegaptanib (Macugen; Pfizer, Inc., New York, USA), (Cunningham et al, 2005;Gonza´ lez et al, 2009), ranibizumab (Lucentis ® ; Genentech, Inc., South San Francisco, California, USA) (Chun et al, 2006;Rosenfeld et al, 2006;Erfurth et al, 2014;Comyn et al, 2014), bevacizumab (Yanyali et al, 2007;Roh et al, 2008;Fang et al, 2008;) …”

Section: Anti Vegf Treatmentmentioning

confidence: 99%

Current and Emerging Therapies for the Management of Diabetic Retinopathy

2017

J App Pharm Sci

View full text Add to dashboard Cite

Diabetes Mellitus (DM) has many complications, in which Diabetic Retinopathy (DR) is the major one. Blindness among working age people was due to DR. Retinal angiogenesis and retinal vascular permeability is the pathogenesis behind vision loss. Polyol pathway, protein kinase C (PKC) activation, renin angiotensinaldosterone system (RAAS), oxidative stress etc are the pathophysiological pathways which are discussed in this review for better understanding. PKC inhibitors, anti-inflammatory agents, RAAS blockers, anti-vascular Endothelial growth factor (VEGF) agents, antioxidants and fibrates which are the used for the better treatment for DR is also elaborated in this review.

show abstract

Intravitreal Triamcinolone Prior to Laser Treatment of Diabetic Macular Edema

Cited by 61 publications

References 28 publications

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

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

Clinical trials on corticosteroids for diabetic macular edema

Current and Emerging Therapies for the Management of Diabetic Retinopathy

Contact Info

Product

Resources

About