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Yoshida S, Murakami T, Nozaki M, Suzuma K, Baba T, Hirano T, Sawada O, Sugimoto M, Takamura Y, Tsuiki E. Review of clinical studies and recommendation for a therapeutic flow chart for diabetic macular edema. Graefes Arch Clin Exp Ophthalmol 2020; 259:815-836. [PMID: 32997288 DOI: 10.1007/s00417-020-04936-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 09/03/2020] [Accepted: 09/10/2020] [Indexed: 12/25/2022] Open
Abstract
Diabetic macular edema (DME), characterized by exudative fluid accumulation in the macula, is the most common form of sight-threatening retinopathy in patients with diabetes. The management of DME has changed considerably in recent years, especially following the development of intravitreal anti-vascular endothelial growth factor therapy which has emerged as a first-line therapy for center-involved DME. Laser treatment, intravitreal steroid therapy, and vitrectomy are also important treatment options for DME. We believe that it is important to choose the most appropriate treatment option for DME based on the clinical evidences, in addition to the careful consideration of individual patients' general or ocular condition, DME characteristics, patients' motivation, and compliance to the treatment in real-world clinical practice. In this review, we have summarized important clinical evidences for the main treatments for DME, presented an expert review for these evidences, and proposed a recommended therapeutic flow chart for DME. We hope that our review of the clinical evidences and the recommended therapeutic flow chart for DME will contribute to better treatment outcome for DME.
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Affiliation(s)
- Shigeo Yoshida
- Department of Ophthalmology, Kurume University School of Medicine, 67 Asahi-machi, Kurume-shi, Fukuoka, 830-0011, Japan.
| | - Tomoaki Murakami
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Miho Nozaki
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1-Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya-Shi, Aichi, 467-8601, Japan
| | - Kiyoshi Suzuma
- Department of Ophthalmology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki-cho, Kagawa, Kita-gun, 761-0793, Japan
| | - Takayuki Baba
- Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8677, Japan
| | - Takao Hirano
- Department of Ophthalmology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto-shi, Nagano, 390-8621, Japan
| | - Osamu Sawada
- Department of Ophthalmology, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu-shi, Shiga, 520-2192, Japan
| | - Masahiko Sugimoto
- Department of Ophthalmology, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu-shi, Mie, 514-8507, Japan
| | - Yoshihiro Takamura
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, 23-3, Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Eiko Tsuiki
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto 1-7-1, Nagasaki-shi, Nagasaki, 852-8523, Japan
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Maeda Y, Ishikawa H, Nishikawa H, Shimizu M, Kinoshita T, Ogihara R, Kitano S, Yamanaka C, Mitamura Y, Sugimoto M, Kondo M, Takamura Y, Ogata N, Ikeda T, Gomi F. Intraocular pressure elevation after subtenon triamcinolone acetonide injection; Multicentre retrospective cohort study in Japan. PLoS One 2019; 14:e0226118. [PMID: 31805140 PMCID: PMC6894825 DOI: 10.1371/journal.pone.0226118] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 11/18/2019] [Indexed: 11/21/2022] Open
Abstract
Purpose To evaluate real-world evidence for intraocular pressure (IOP) elevation after subtenon triamcinolone acetonide injection (STTA) in 1252 Japanese patients (1406 eyes) in the Japan Clinical REtina STudy group (J-CREST). Methods This was a multicentre retrospective study of the medical records of 1252 patients (676 men (758 eyes); mean age: 63.8 ± 12.9 years) who received STTA in participating centres between April 2013 and July 2017. Results IOP elevation was observed in 206 eyes (14.7%) and IOP increase ≥ 6 mmHg was found in 328 eyes (23.3%). In total, 106 eyes (7.5%) needed medication and two eyes (0.14%) needed surgical procedures. Younger age, higher baseline IOP, and steroid dose were risk factors associated with IOP elevation. Risk factors associated with IOP increase ≥ 6 mmHg were younger age, lower baseline IOP, steroid dose, and higher incidences of diabetic macular oedema (DME) and uveitis. In contrast, with steroid dose fixed at 20 mg, a lower incidence of DME was a risk factor for increased IOP, suggesting that STTA had dose-dependent effects on IOP increase, especially in patients with DME. Conclusion Our real-world evidence from a large sample of Japanese patients who received STTA showed that the incidence of IOP elevation after STTA was 14.7%, and was associated with younger age, higher baseline IOP, and steroid dose. Thus, IOP should be monitored, especially in patients with younger age, higher baseline IOP, and higher incidences of DME and uveitis.
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Affiliation(s)
- Yuki Maeda
- J-CREST (Japan Clinical REtina STudy group), Kagoshima, Japan
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Hiroto Ishikawa
- J-CREST (Japan Clinical REtina STudy group), Kagoshima, Japan
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Japan
- * E-mail:
| | - Hiroki Nishikawa
- Center for Clinical Research and Education, Hyogo College of Medicine, Nishinomiya, Japan
| | - Miho Shimizu
- J-CREST (Japan Clinical REtina STudy group), Kagoshima, Japan
- Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan
| | - Takamasa Kinoshita
- J-CREST (Japan Clinical REtina STudy group), Kagoshima, Japan
- Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan
| | - Rie Ogihara
- J-CREST (Japan Clinical REtina STudy group), Kagoshima, Japan
- Department of Ophthalmology, Diabetes Center, Tokyo Women's Medical University School of Medicine, Shinjuku-ku, Japan
| | - Shigehiko Kitano
- J-CREST (Japan Clinical REtina STudy group), Kagoshima, Japan
- Department of Ophthalmology, Diabetes Center, Tokyo Women's Medical University School of Medicine, Shinjuku-ku, Japan
| | - Chihiro Yamanaka
- J-CREST (Japan Clinical REtina STudy group), Kagoshima, Japan
- Department of Ophthalmology, Tokushima University, Tokushima, Japan
| | - Yoshinori Mitamura
- J-CREST (Japan Clinical REtina STudy group), Kagoshima, Japan
- Department of Ophthalmology, Tokushima University, Tokushima, Japan
| | - Masahiko Sugimoto
- J-CREST (Japan Clinical REtina STudy group), Kagoshima, Japan
- Department of Ophthalmology, Mie University, Tsu, Japan
| | - Mineo Kondo
- J-CREST (Japan Clinical REtina STudy group), Kagoshima, Japan
- Department of Ophthalmology, Mie University, Tsu, Japan
| | - Yoshihiro Takamura
- J-CREST (Japan Clinical REtina STudy group), Kagoshima, Japan
- Department of Ophthalmology, Fukui University, Yoshida, Japan
| | - Nahoko Ogata
- J-CREST (Japan Clinical REtina STudy group), Kagoshima, Japan
- Department of Ophthalmology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Tomohiro Ikeda
- J-CREST (Japan Clinical REtina STudy group), Kagoshima, Japan
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Fumi Gomi
- J-CREST (Japan Clinical REtina STudy group), Kagoshima, Japan
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Japan
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Yamada Y, Takamura Y, Matsumura T, Morioka M, Gozawa M, Inatani M. Posterior subtenon infusion of triamcinolone acetonide as adjunctive treatment to panretinal photocoagulation using pattern scan laser for diabetic retinopathy. Jpn J Ophthalmol 2018; 62:686-692. [PMID: 30328560 DOI: 10.1007/s10384-018-0628-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 08/31/2018] [Indexed: 11/27/2022]
Abstract
PURPOSE To estimate the effect of sub-Tenon's capsule triamcinolone acetonide injection (STTA) combined with panretinal photocoagulation (PRP) using pattern scan laser (PSL) for high risk non-proliferative diabetic retinopathy (NPDR), in terms of the inflammation and the progression of diabetic macular edema (DME). STUDY DESIGN Retrospective comparative analysis. METHODS NPDR patients who underwent PRP using PSL with (STTA+PSL group, n=24) or without (PSL group, n=19) pretreatment of STTA were enrolled. We measured anterior flare intensity (AFI) and central retinal thickness (CRT) at day of STTA (day 0), and at 1, 3, 7, 11 and 15 weeks. RESULTS The CRT of the STTA+PSL group was significantly lower than that of the PSL group at 7 (308.15±69.16 μm versus 340.21±77.91 μm, p = 0.04), 11 (283.8±60.75 μm versus 335.7±67.70 μm, p = 0.01) and 15 weeks (281.13±35.29 μm versus 316.58±54.89 μm, p = 0.02). AFI levels in the STTA+PSL group were significantly lower than those in the PSL group at 11 (10.47±3.40 versus 15.85±8.38, p = 0.007) and 15 weeks (11.38±3.31 versus 14.37±3.85, p = 0.009). The significant improvement in CRT from baseline was noticed through the observational periods in STTA+PSL group, but not in the PSL group. CONCLUSION Pretreatment of STTA has the potential to not only prevent the worsening of DME, but also reduce the CRT and AFI of eyes with NPDR after PRP using PSL.
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Affiliation(s)
- Yutaka Yamada
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui, Fukui-ken, 910-1193, Japan
| | - Yoshihiro Takamura
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui, Fukui-ken, 910-1193, Japan.
| | - Takehiro Matsumura
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui, Fukui-ken, 910-1193, Japan
| | - Masakazu Morioka
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui, Fukui-ken, 910-1193, Japan
| | - Makoto Gozawa
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui, Fukui-ken, 910-1193, Japan
| | - Masaru Inatani
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Eiheiji-cho, Yoshida-gun, Fukui, Fukui-ken, 910-1193, Japan
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Kakimoto H, Takamura Y, Arimura S, Miyake S, Matsumura T, Gozawa M, Iwasaki K, Morioka M, Yamada Y, Inatani M. Effect of 0.05% Difluprednate Ophthalmic Emulsion on Proinflammatory Cytokine Levels After Retinal Laser Photocoagulation in Rabbits. J Ocul Pharmacol Ther 2018; 34:410-415. [PMID: 29812993 DOI: 10.1089/jop.2017.0109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE We aimed to evaluate the effect of the topical application of a strong corticosteroid, difluprednate, on the levels of inflammatory and angiogenic cytokine in the vitreous and aqueous humor after laser photocoagulation. METHODS Pigmented rabbits were treated with retinal laser photocoagulation and divided into 4 groups, namely control (no additional treatment), topical application of difluprednate 0.05%, betamethasone sodium phosphate 0.1%, and sub-Tenon injection of triamcinolone acetonide (STTA). Samples of vitreous and aqueous humor were collected on posttreatment days 0, 1, 7, and 14. The levels of intraocular vascular endothelial growth factor (VEGF), interleukin-6 (IL-6), intercellular adhesion molecule-1 (ICAM-1), and monocyte chemotactic protein-1 (MCP-1) were measured using an immunoassay. Intraocular pressure (IOP) was monitored in each group. RESULTS VEGF, IL-6, ICAM-1, and MCP-1 were significantly elevated on day 1 and were reduced in both the vitreous and aqueous humor following topical application of difluprednate and STTA. Topical betamethasone reduced their levels in the aqueous humor but not in the vitreous. A significant increase of IOP induced by difluprednate returned to control levels after withdrawal of administration. CONCLUSION Although the elevation of IOP was an expected, manageable side effect, topical application of difluprednate was more effective than STTA and betamethasone for reducing inflammatory cytokine levels after laser treatment.
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Affiliation(s)
- Hiroshi Kakimoto
- Department of Ophthalmology, Faculty of Medical Science, University of Fukui , Fukui, Japan
| | - Yoshihiro Takamura
- Department of Ophthalmology, Faculty of Medical Science, University of Fukui , Fukui, Japan
| | - Shogo Arimura
- Department of Ophthalmology, Faculty of Medical Science, University of Fukui , Fukui, Japan
| | - Seiji Miyake
- Department of Ophthalmology, Faculty of Medical Science, University of Fukui , Fukui, Japan
| | - Takehiro Matsumura
- Department of Ophthalmology, Faculty of Medical Science, University of Fukui , Fukui, Japan
| | - Makoto Gozawa
- Department of Ophthalmology, Faculty of Medical Science, University of Fukui , Fukui, Japan
| | - Kentaro Iwasaki
- Department of Ophthalmology, Faculty of Medical Science, University of Fukui , Fukui, Japan
| | - Masakazu Morioka
- Department of Ophthalmology, Faculty of Medical Science, University of Fukui , Fukui, Japan
| | - Yutaka Yamada
- Department of Ophthalmology, Faculty of Medical Science, University of Fukui , Fukui, Japan
| | - Masaru Inatani
- Department of Ophthalmology, Faculty of Medical Science, University of Fukui , Fukui, Japan
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Reduction in the frequency of intravitreal bevacizumab administrations achieved by posterior subtenon injection of triamcinolone acetonide in patients with diffuse diabetic macular edema. Jpn J Ophthalmol 2016; 60:401-7. [PMID: 27306783 DOI: 10.1007/s10384-016-0458-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Accepted: 04/26/2016] [Indexed: 12/22/2022]
Abstract
PURPOSE To evaluate the effectiveness of posterior subtenon injections of triamcinolone acetonide (STTA) during treatment with intravitreal injections of bevacizumab (IVB) in eyes with diffuse diabetic macular edema (DDME). METHODS Forty eyes of 20 patients with bilateral DDME with foveal thickness (FT) greater than 400 μm were studied. Initially, both eyes of each patient received 1.25 mg/0.05 ml of IVB. One eye then received 20 mg/0.5 ml of STTA at the onset and at 16, 32, and 48 weeks. For the control, the other eye was not treated with STTA. Patients were treated with additional IVB when DDME recurred during the study to maintain the FT at <350 μm. The FT, logMAR visual acuity (VA), and intraocular pressure (IOP) were monitored monthly for 56 weeks. The total number of IVB injections during the 1-year follow-up was also calculated. RESULTS STTA-treated eyes had significantly more regression of FT and improvement of VA at several time points during the study than did the controls. The mean (SD) required number of IVB injections in the STTA-treated eyes during the study was 5.00 ± 1.75, which was significantly less than the 7.95 ± 1.57 in the control eyes. CONCLUSIONS Adjunctive STTA therapy to IVB for the treatment of DDME not only improved the morphological and functional regressions but also reduced the frequency of IVB treatments.
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Ercalik NY, Yenerel NM, Imamoglu S, Kumral ET, Vural ET. Combined Intravitreal Ranibizumab and Sub-Tenon Injection of Triamcinolone for the Treatment of Diabetic Macular Edema with Retinal Detachment. J Ocul Pharmacol Ther 2016; 32:225-9. [PMID: 27092435 DOI: 10.1089/jop.2015.0092] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To evaluate the efficacy of intravitreal ranibizumab (IVR) combined with posterior sub-Tenon injection of triamcinolone acetonide (STTA) for treatment of diabetic macular edema (DME) with serous retinal detachment (SRD). METHODS Eighty-five eyes of 65 patients with DME and SRD were enrolled in this retrospective study. Fifty-eight eyes were treated with IVR and STTA (combined group), whereas 27 eyes were treated with pro re nata (PRN) IVR (control group). The combined group patients received a single and the control group patients received mean 1.29 ± 0.46 injections and followed for 3 months. The primary outcome measures were change in central macular thickness (CMT) and best corrected visual acuity (BCVA). The secondary outcome measure was the complication rate. RESULTS In the combined group, mean initial CMT was 543.9 ± 133.5 μm. Macular thickness was significantly reduced both after 1 month (334 ± 88 μm; P < 0.001) and after 3 months (387.6 ± 131.9 μm; P < 0.001) of treatment. At the 3-month follow-up, BCVA improved in 37.2% of the eyes. Complications were drug reflux at the time of STTA injection, elevation of intraocular pressure, and migration of hard exudates to the fovea. The decrease in CMT was statistically significant in the combined group in the first month, but not in the third month compared with the control group. The improvement in BCVA was not statistically significant between the 2 groups both after the first and third months. SRD disappeared with a higher rate with the combined therapy in the first month. CONCLUSION IVR and STTA seem to be effective in improving BCVA in DME with SRD.
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Affiliation(s)
| | | | - Serhat Imamoglu
- Haydarpaşa Numune Research and Training Hospital , Istanbul, Turkey
| | | | - Ece Turan Vural
- Haydarpaşa Numune Research and Training Hospital , Istanbul, Turkey
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Pickrell A, Harris A, Ngo S, Amireskandari A, Stewart E, Siesky B. Delivery of intraocular triamcinolone acetonide in the treatment of macular edema. Pharmaceutics 2012; 4:230-42. [PMID: 24300190 PMCID: PMC3834899 DOI: 10.3390/pharmaceutics4010230] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 02/28/2012] [Accepted: 03/09/2012] [Indexed: 12/02/2022] Open
Abstract
Macular edema (ME) is one of the eventual outcomes of various intraocular and systemic pathologies. The pathogenesis for ME is not yet entirely understood; however, some of the common risk factors for its development have been identified. While this investigation will not discuss the numerous etiologies of ME in detail, it appraises the two most widely studied delivery modalities of intraocular corticosteroids in the treatment of ME—intravitreal injection (IVI) and sub-Tenon’s infusion (STI). A thorough review of the medical literature was conducted to identify the efficacy and safety of IVI and STI, specifically for the administration of triamcinolone acetonide (TA), in the setting of ME in an attempt to elucidate a preferred steroid delivery modality for treatment of ME.
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Affiliation(s)
- Aaron Pickrell
- Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, 1160 W. Michigan Street, Room 205Q, Indianapolis, IN 46202, USA.
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Ha SW, Kim MJ, Park DH, Kim SY, Shin JP. Surgical Removal of Sub-Tenon Triamcinolone Acetonide in Cases of Increased Intraocular Pressure after Sub-Tenon Injection. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2012. [DOI: 10.3341/jkos.2012.53.1.175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Sang Won Ha
- Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Myoung Jun Kim
- Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Dong Ho Park
- Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Si Yeol Kim
- Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jae Pil Shin
- Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, Korea
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Suppression of phagocytic cells in retinal disorders using amphiphilic poly(γ-glutamic acid) nanoparticles containing dexamethasone. J Control Release 2011; 151:65-73. [DOI: 10.1016/j.jconrel.2010.11.029] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Revised: 11/22/2010] [Accepted: 11/26/2010] [Indexed: 11/19/2022]
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Chew EY, Glassman AR, Beck RW, Bressler NM, Fish GE, Ferris FL, Kinyoun JL. Ocular side effects associated with peribulbar injections of triamcinolone acetonide for diabetic macular edema. Retina 2011; 31:284-9. [PMID: 20948459 PMCID: PMC3489034 DOI: 10.1097/iae.0b013e3181f049a8] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate long-term effects of anterior and posterior peribulbar injections of triamcinolone acetonide on intraocular pressure (IOP) elevation and cataract development. METHODS This study reports on IOP and cataract progression through 2 years in 96 eyes with diabetic macular edema randomized to focal/grid photocoagulation, 20 mg triamcinolone acetonide anterior injection, anterior injection followed by laser, 40 mg triamcinolone acetonide posterior injection, or posterior injection followed by laser. RESULTS Intraocular pressure increased from baseline by ≥ 10 mmHg at ≥ 1 visit through 2 years in 2 eyes (8%) in the laser group, 11 eyes (31%) in the anterior groups, and 6 eyes (17%) in the posterior groups. Among phakic eyes at baseline, 0, 5 (17%), and 1 (3%) in the 3 groups, respectively, underwent cataract surgery before the 2-year visit. CONCLUSION Based on this small randomized trial, it appears that over 2 years, anterior peribulbar triamcinolone acetonide injections are associated with an increased incidence of IOP elevation and an increased risk of cataract development compared with laser or posterior peribulbar injections. The association of posterior injections with IOP elevation is less certain. Although the study involved eyes with diabetic macular edema, the results should be relevant to other conditions treated with peribulbar corticosteroids.
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Affiliation(s)
- Emily Y Chew
- National Eye Institute/National Institutes of Health, Bethesda, Maryland, USA
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Current World Literature. Curr Opin Ophthalmol 2010; 21:239-46. [DOI: 10.1097/icu.0b013e32833983a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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