Subconjunctival Triamcinolone Acetonide in the Management of Ocular Inflammatory Disease

Athanasiadis, Yannis; Tsatsos, Michael; Sharma, Anant; Hossain, Parwez

doi:10.1089/jop.2012.0208

Cited by 38 publications

(28 citation statements)

References 71 publications

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“…Dexamethasone has been shown to achieve good ocular penetration following sub‐conjunctival injection, with higher levels of concentration in the aqueous and vitreous than when it is administered as a peribulbar injection or orally . Sub‐conjunctival TA has been shown to be efficacious and safe for anterior uveitis and non‐necrotising, non‐infectious anterior scleritis …”

Section: Steroid Preparations and Methods Of Local Administration To mentioning

confidence: 99%

“…Where anterior uveitis has not adequately responded to topical corticosteroids, periocular steroids such as sub‐conjunctival dexamethasone may provide greater therapeutic effect with a short duration of action of 1 to 2 days . Similarly, sub‐conjunctival triamcinolone or betamethasone has also been shown to be safe and effective in severe cases of anterior uveitis …”

Section: Uses Of Locally Administered Steroidsmentioning

confidence: 99%

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Local delivery of corticosteroids in clinical ophthalmology: A review

Fung

Tran

Lim

et al. 2020

Clinical Exper Ophthalmology

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Locally administered steroids have a long history in ophthalmology for the treatment of inflammatory conditions. Anterior segment conditions tend to be treated with topical steroids whilst posterior segment conditions generally require periocular, intravitreal or systemic administration for penetration. Over recent decades, the clinical applications of periocular steroid delivery have expanded to a wide range of conditions including macular oedema from retino-vascular conditions. Formulations have been developed with the aim to provide practical, targeted, longer-term and more efficacious therapy whilst minimizing side effects. Herein, we provide a comprehensive overview of the

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Section: Steroid Preparations and Methods Of Local Administration To mentioning

confidence: 99%

Section: Uses Of Locally Administered Steroidsmentioning

confidence: 99%

Local delivery of corticosteroids in clinical ophthalmology: A review

Fung

Tran

Lim

et al. 2020

Clinical Exper Ophthalmology

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“…Periocular administration of corticosteroids using the subconjunctival route as a depot can be an attractive alternative as it leads to high local drug levels that are necessary to alleviate postoperative inflammation, especially in the setting of a corneal transplant [17–19]. Several studies have reported better clinical outcomes, such as reduction in neovascularization, preservation of corneal clarity and reduction of inflammation, with subconjunctival depot injections of steroids [17,18,20–23]. A single subconjunctival corticosteroid administration results in higher drug concentration than several topical administrations [17,24,25].…”

Section: Introductionmentioning

confidence: 99%

Subconjunctival injectable dendrimer-dexamethasone gel for the treatment of corneal inflammation

et al. 2017

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Corneal inflammation is often encountered as a key pathological event in many corneal diseases. Current treatments involve topical corticosteroids which require frequent instillations due to rapid tear turnover, causing side-effects such as corneal toxicity and elevated intraocular pressure (IOP). Hence, new interventions that can reduce side effects, dosing frequency, and increase patient compliance can be highly beneficial. In this study, we explore a subconjunctival injectable gel based on G4-PAMAM dendrimer and hyaluronic acid, cross-linked using thiol-ene click chemistry, incorporated with dendrimer dexamethasone (D-Dex) conjugates as a potential strategy for sustained delivery and enhanced bioavailability of corticosteroids. The efficacy of the injectable gel formulation was evaluated in a rat mild alkali burn model. Fluorescently-labelled dendrimers (D-Cy5) incorporated in the gel release D-Cy5 in vivo. The released D-Cy5 selectively targets and localizes within corneal macrophages in inflamed rat cornea but not in healthy controls. This pathology dependent biodistribution was exploited for drug delivery, by incorporating D-Dex in the injectable gel. The attenuation of corneal inflammation by D-Dex gels was assessed using various clinical and biochemical parameters over a 2-week period. Subconjunctival D-Dex gel treatment resulted in favorable clinically-relevant outcomes with reduced central corneal thickness and improved corneal clarity compared to free-Dex and placebo gel controls. The extent of corneal neovascularization was significantly reduced in the D-Dex group. These findings suggest that D-Dex attenuates corneal inflammation more effectively than free-Dex by attenuating macrophage infiltration and pro-inflammatory cytokines expression. A significant elevation in IOP was not observed in the D-Dex group but was observed in the free-Dex group. This novel injectable D-Dex gel may be a potential drug delivery platform for the treatment of many inflammatory ocular surface disorders such as dry eye, autoimmune keratitis and post-surnical complications where frequent steroid administration is required.

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“…The results showed that all treatment groups had clinically meaningful reductions in central subretinal thickness compared with baseline 15 . However, subconjunctival injections of TA have rarely been reported [14][15][16] .…”

Section: Discussionmentioning

confidence: 99%

Subconjunctival injections of triamcinolone acetonide to treat uveitic macular edema

Liu

Liang

et al. 2020

Preprint

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Background: To evaluate the efficacy and safety of subconjunctival triamcinolone acetonide (TA) injections for treating uveitic macular edema (UME). Methods: This retrospective case series study included patients with UME who received subconjunctival TA injections with a minimum follow-up period of 6 months. The main outcome measure was central macular thickness. The secondary outcome measures included best corrected visual acuity, recurrence rate and intraocular pressure. Results: In total, 68 patients (83 eyes) were enrolled in this study. The mean CMT decreased from 456.9 ± 171.1 μm at baseline to 324 ± 175.9 μm, 305.6 μm ± 147.7 μm, 331.8 ± 154.3 μm and 281.1 ± 147.6 μm at 1-, 2-, 3- and 6-months post injection, respectively (all P < 0.01). A total of 21/83 eyes exhibited elevated IOPs, of which 14 were controlled with topical IOP-lowering agents and 7 eyes underwent surgical removal of subconjunctival TA deposit. Conclusion: Subconjunctival TA injections appear to be safe and effective for UME.

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Subconjunctival Triamcinolone Acetonide in the Management of Ocular Inflammatory Disease

Abstract: This article highlights the potential of TA to complement the treatment armamentarium of anterior segment inflammation.

Cited by 38 publications

References 71 publications

Local delivery of corticosteroids in clinical ophthalmology: A review

Local delivery of corticosteroids in clinical ophthalmology: A review

Subconjunctival injectable dendrimer-dexamethasone gel for the treatment of corneal inflammation

Subconjunctival injections of triamcinolone acetonide to treat uveitic macular edema

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