Vessel diameter study: intravitreal vs posterior subtenon triamcinolone acetonide injection for diabetic macular edema

Kurt, Muhammed; Çekıç, Osman; Akpolat, Çetin; Aslankurt, Murat; Elçioğlu, Mustafa Nuri

doi:10.1038/eye.2017.46

Cited by 9 publications

(4 citation statements)

References 48 publications

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“…28 Kurt et al stated that intravitreal and subtenon triamcinolone may lead to a significant constriction of retinal arteries and veins in DME. 29 According to a study evaluating the vascular changes in retinal vein occlusion, the deep retinal vessels become less telangiectatic after dexamethasone treatment. 30 Inflammation has been identified as a leading factor for vessel stiffness in diabetes.…”

Section: Discussionmentioning

confidence: 99%

Macular and peripapillary microvasculature after dexamethasone injection in diabetic macular edema

Özçalışkan

Pehlivanoğlu

Hüseyinhan

et al. 2021

European Journal of Ophthalmology

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Purpose To evaluate the microvascular changes in the macular and peripapillary area after intravitreal dexamethasone implant in diabetic macular edema (DME) Material and Methods We included 31 eyes of 31 patients treated with a single dose dexamethasone implant for DME. All subjects underwent swept-source optical coherence tomography (OCT) and OCT angiography imaging before (T0), and one month (T1), two months (T2), and four months (T4) after dexamethasone injection. The foveal avascular zone (FAZ) area of superficial and deep capillary plexus (SCP and DCP) was calculated by delineating the FAZ border using the measurement tool of the device. The vessel density (VD) of SCP and DCP and choriocapillaris (CC) in the macular and peripapillary area were automatically calculated. Results There was an insignificant reduction in FAZ area measurements of SCP after dexamethasone injection in DME patients (p = 0.846). The FAZ area of DCP were significantly smaller compared to T0 measurements at T1, T2, and T4 (p = 0.013, p = 0.031, and p = 0.029, respectively). The mean average parafoveal VD measurements were significantly decreased after dexamethasone injection in SCP and DCP (p = 0.004, p = 0.005). The peripapillary VD in retinal capillary plexuses and choriocapillaris showed no significant difference after dexamethasone injection. Conclusion Intravitreal dexamethasone leads to a significant FAZ area decrease in DCP with a reduction in parafoveal VD measurements. In addition, no significant VD changes were observed in the peripapillary area after dexamethasone. These findings indicate that dexamethasone may improve macular ischemia with no significant effects on peripapillary microvasculature in DME patients.

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Section: Discussionmentioning

confidence: 99%

Macular and peripapillary microvasculature after dexamethasone injection in diabetic macular edema

Özçalışkan

Pehlivanoğlu

Hüseyinhan

et al. 2021

European Journal of Ophthalmology

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“…Kurt et al. recently reported similar anatomic and functional improvements after both IVTA and STTAI administrations in diabetic eyes [ 29 ]. Moreover, in this study, both routes of injection led to a significant constriction of retinal arteries and veins and, as a result, to the decline of vascular permeability and leakage [ 30 ].…”

Section: Discussionmentioning

confidence: 93%

Combined therapy with intravitreal aflibercept and subtenon corticosteroids in eyes with severe diabetic papillopathy: two case reports

Arapi

Neri²,

Giovannini

et al. 2021

J Med Case Reports

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Background Diabetic papillopathy is a rare diagnosis of exclusion characterized by unilateral or bilateral optic disc edema with variable degrees of visual loss. Although the visual prognosis has been generally reported as favorable, the presence of severe disc edema associated with macular edema prompts the need for treatment. We present a specific and unreported therapeutic approach consisting of intravitreal aflibercept and subtenon triamcinolone acetonide injections in two patients with evidence of diabetic papillopathy and macular edema. Case presentation In the first case, a 60-year-old Caucasian woman affected by type II diabetes mellitus presented with fundoscopic evidence of sequential bilateral optic disc edema associated with acute severe visual loss in both eyes. The second patient, a diabetic 57-year-old Caucasian male, presented with sudden painless visual loss in his left eye. Multimodal imaging and systemic findings correlated towards an infrequent diagnosis of diabetic papillopathy. In a period of 5–7 weeks after treatment, both patients experienced almost full visual and anatomical recovery. A steady situation was observed at 12 months of follow-up. Conclusions Both our cases displayed a severe grade of optic disc edema, which was optimally reversed with intravitreal aflibercept and subtenon triamcinolone acetonide leading to a relatively rapid and safe improvement in visual acuity.

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“…TA is a corticosteroid that has antiangiogenic and anti-inflammatory effects that can inhibit VEGF and other cytokines, which enter the pathogenesis of macular edema due to RVOs and produce changes in the diameter and perfusions of the retinal vessel, improving BCVA and decreasing CMT [7,12,13] . Kurt et al [14] found some associations between vessel diameter, CMT, and IOP values after triamcinolone injection, suggesting that posterior subtenon TA injection causes retinal vessels constriction leading to a decrease in CMT and increase in the BCVA, which will be helpful in understanding the action mechanism of triamcinolone.…”

Section: Explanation Of the Main Finding Of The Studymentioning

confidence: 99%

Efficacy of Formulated Posterior Sub Tenon Triamcinolone in macular Edema secondary to Non–Ischemic Retinal Vein Occlusions

Tharwat

Elgazar

Ahmed

2022

International Journal of Medical Arts

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Article informationBackground: Retinal vein occlusion [RVO] is considered the second vascular disorder of the retina after diabetic retinopathy. Patients with RVO are at risk of the development of macular edema, which may be treated by triamcinolone. The Aim of the work:To detect the efficacy of formulated Triamcinolone Acetonide [TA] injection in the posterior subtenon space to manage macular edema secondary to non-ischemic RVOs, either central or branch.Patients and methods: Our study included forty-six eyes from 46 patients with non-ischemic RVO. All the eyes received a single dose of 40 mg of Triamcinolone Acetonide [TA] and VISCOAT, which is 20 mg sodium chondroitin sulfate and 15 mg sodium hyaluronate [0.5 ml] through the posterior subtenon route using NAGATA subtenon canula. Complete ophthalmic examinations were done at the baseline and after one, three, and six months of injections. Result: The mean age of patients was 58.28±5.19 years. BCVA increased from 0.40 [0.10-0.70] at baseline to 0.75 [0.10-1.00] at the 1st ,3rd and 6th month [P < 0.001]. The median baseline OCT thickness changed from 411.50 [294.00-624.00] μm pre-injection to 265.00[187.00-614.00] μm [1st month], 265.00 [187.00-614.00] μm [3rd month], and 209.00 [178.00-531.00] m [6th month] [p<0.001]. The median IOP decreased from 13.00 [11.00-18.00] mm Hg on initial assessment to 12.00 [10.00-16.00] at the end of the study without any elevation at any point. Conclusion: Formulated posterior subtenon triamcinolone acetonide [PSTA] is an effective treatment for macular edema secondary to Non-Ischemic RVO with minimal complications.

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Vessel diameter study: intravitreal vs posterior subtenon triamcinolone acetonide injection for diabetic macular edema

Cited by 9 publications

References 48 publications

Macular and peripapillary microvasculature after dexamethasone injection in diabetic macular edema

Macular and peripapillary microvasculature after dexamethasone injection in diabetic macular edema

Combined therapy with intravitreal aflibercept and subtenon corticosteroids in eyes with severe diabetic papillopathy: two case reports

Efficacy of Formulated Posterior Sub Tenon Triamcinolone in macular Edema secondary to Non–Ischemic Retinal Vein Occlusions

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