Regression of Optic Nerve Head Neovascularization in Proliferative Diabetic Retinopathy After Intravitreal Triamcinolone Regression of Diabetic Optic Disc Neovascularization After Intravitreal Triamcinolone

Karaçorlu, Murat; Özdemir, Hakan; Karacorlu, Serra; Alacali, Nilay

doi:10.1023/b:inte.0000031740.85124.78

Cited by 16 publications

(13 citation statements)

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“…For decades, studies have suggested that IVTA may be useful to temporarily increase visual acuity in patients with diffuse DME [18,19,21,22,23,24,25,26,27,28,29,30,31,32,33,34]. The most convincing evidence came from a prospective, double-masked, placebo-controlled and randomized trial by Sutter et al [34].…”

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

confidence: 99%

“…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%

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

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intravitreal Triamcinolone

Tao

Jonas

2010

Ophthalmologica

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“…In a similar manner, Zacks and Johnson [51] concluded that combination treatment of panretinal laser coagulation and intravitreal triamcinolone acetonide may provide benefit in patients with diffuse diabetic macular edema who require urgent laser treatment for proliferative diabetic retinopathy by preventing an exacerbation of macular edema. Karacorlu et al [30] reported on the clinical outcome of a patient with proliferative diabetic retinopathy and diabetic macular edema which progressed despite grid laser photocoagulation in the macular region. After a single intravitreal injection of 4 mg triamcinolone acetonide, visual acuity increased, macular edema decreased, and neovascularization of the optic nerve head markedly regressed.…”

Section: Diabetic Macular Edema and Proliferative Diabetic Retinopathmentioning

confidence: 99%

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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“…This approach can be useful to prevent the exacerbation of the macular oedema, however it will not treat pre-existing macular oedema. Intravitreal triamcinolone acetonide (TA) has been shown to be clinically effective in cases of intraocular inflammatory, oedematous, neovascular and proliferative disorders [11][12][13][14]. With reference to these effects, TA usage in the treatment of concomitant non-high-risk PDR and diffuse CSMO is reasonable.…”

Section: Introductionmentioning

confidence: 99%