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Chen S, Kong J, Feng L. The Trend of Drug Therapy on Uveitic Macular Edema: A Bibliometric Analysis of the 100 Most Cited Articles. Front Med (Lausanne) 2022; 9:807319. [PMID: 35280901 PMCID: PMC8904366 DOI: 10.3389/fmed.2022.807319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/31/2022] [Indexed: 01/12/2023] Open
Abstract
Background Macular edema is the most common cause of impaired vision due to uveitis. Although various medications are available, not all uveitis patients with macular edema are satisfied with the treatment results. Therefore, solving this gap becomes the utmost concern worldwide. This study attempted to use bibliometric analysis to compare the valuable information in the top 100 highly cited studies in the field of drug therapy for uveitic macular edema (UME) and then determine the research hot spots and trends in this field. Methods In this study, the Science Citation Index Expanded (SCIE) of Web of Science (WOS) was used to collect the top 100 most cited studies on UME and analyze the literature from different countries/regions, institutions, and journals. The visualization knowledge maps is generated by VOSviewer and Citespace software. Results The top 100 highly cited studies are from 34 countries/regions. The United States has the largest number of publications, followed by the England, Spain and Germany. The top three institutions publishing highly cited literature are all from the England: University of London, University College London, and Moorfields Eye Hospital NHS Foundation Trust. Ophthalmology is the most widely published journal with 14 papers. The total number of citations is 1,371, meaning that Ophthalmology is the most authoritative journal in the field of UME drug therapy. The top two articles with the most cited times are from the United States, accounting for 36.5% of the total cited times of the top 10 articles. Keywords were divided into three clusters: the corticosteroid administration pathway, biological agents, and clinical trials. Uveitis, cystoid macular edema, efficacy, dexamethasone, and triamcinolone acetonide appeared more frequently in keywords. Researches on local and long-acting drug has gradually becoming the hot spots and trends. Conclusion This study concludes that bibliometric analysis can intuitively and quickly obtain the frontiers and hot spots of research in the field of UME drug therapy. Corticosteroid administration, biological agents, and clinical trials are considered the potential focus of future research.
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Affiliation(s)
- Si Chen
- Eye Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.,Department of Ophthalmology, Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, China
| | - Jinfeng Kong
- Eye Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Lei Feng
- Eye Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
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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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Thorne JE, Sugar EA, Holbrook JT, Burke AE, Altaweel MM, Vitale AT, Acharya NR, Kempen JH, Jabs DA. Periocular Triamcinolone vs. Intravitreal Triamcinolone vs. Intravitreal Dexamethasone Implant for the Treatment of Uveitic Macular Edema: The PeriOcular vs. INTravitreal corticosteroids for uveitic macular edema (POINT) Trial. Ophthalmology 2018; 126:283-295. [PMID: 30269924 DOI: 10.1016/j.ophtha.2018.08.021] [Citation(s) in RCA: 120] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 08/07/2018] [Accepted: 08/14/2018] [Indexed: 12/29/2022] Open
Abstract
PURPOSE To evaluate the comparative effectiveness of 3 regional corticosteroid injections for uveitic macular edema (ME): periocular triamcinolone acetonide (PTA), intravitreal triamcinolone acetonide (ITA), and the intravitreal dexamethasone implant (IDI). DESIGN Multicenter, randomized clinical trial. PARTICIPANTS Patients with uveitic ME. METHODS Patients were randomized 1:1:1 to receive 1 of the 3 therapies. Patients with bilateral ME were assigned the same treatment for both eyes. MAIN OUTCOME MEASURES The primary outcome was the proportion of baseline (PropBL) central subfield thickness (CST) at 8 weeks (CST at 8 weeks/CST at baseline) assessed with OCT by masked readers. Secondary outcomes included ≥20% improvement and resolution of ME, best-corrected visual acuity (BCVA), and intraocular pressure (IOP) events over 24 weeks. RESULTS All treatment groups demonstrated improved CST during follow-up. At 8 weeks, each group had clinically meaningful reductions in CST relative to baseline (PropBL: 0.77, 0.61, and 0.54, respectively, which translates to reductions of 23%, 39%, and 46% for PTA, ITA, and IDI, respectively). Intravitreal triamcinolone acetonide (PropBL ITA/PropBL PTA, hazard ratio [HR], 0.79; 99.87% confidence interval [CI], 0.65-0.96) and IDI (PropBL IDI/PropBL PTA, HR, 0.69; 99.87% CI, 0.56-0.86) had larger reductions in CST than PTA (P < 0.0001). Intravitreal dexamethasone implant was noninferior to ITA at 8 weeks (PropBL IDI/PropBL ITA, HR, 0.88; 99.87% CI, 0.71-1.08). Both ITA and IDI treatments also were superior to PTA treatment in improving and resolving uveitic ME. All treatment groups demonstrated BCVA improvement throughout follow-up. Both ITA and IDI groups had improvements in BCVA that was 5 letters greater than in the PTA group at 8 weeks (P < 0.004). The risk of having IOP ≥24 mmHg was higher in the intravitreal treatment groups compared with the periocular group (HR, 1.83; 95% CI, 0.91-3.65 and HR, 2.52; 95% CI, 1.29-4.91 for ITA and IDI, respectively); however, there was no significant difference between the 2 intravitreal treatment groups. CONCLUSIONS Intravitreal triamcinolone acetonide and the IDI were superior to PTA for treating uveitic ME with modest increases in the risk of IOP elevation. This risk did not differ significantly between intravitreal treatments.
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Affiliation(s)
- Jennifer E Thorne
- Department of Ophthalmology, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Center for Clinical Trials and Data Synthesis, Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
| | - Elizabeth A Sugar
- Center for Clinical Trials and Data Synthesis, Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Center for Clinical Trials and Data Synthesis, Department of Biostatistics, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Janet T Holbrook
- Center for Clinical Trials and Data Synthesis, Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Alyce E Burke
- Center for Clinical Trials and Data Synthesis, Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Michael M Altaweel
- The Fundus Photograph Reading Center, Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Albert T Vitale
- Department of Ophthalmology, University of Utah, Salt Lake City, Utah
| | - Nisha R Acharya
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California; Department of Epidemiology, University of California, San Francisco, San Francisco, California
| | - John H Kempen
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts; Eye Unit, MyungSung Christian Medical Center and MyungSung Medical School, Addis Ababa, Ethiopia
| | - Douglas A Jabs
- Center for Clinical Trials and Data Synthesis, Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Department of Ophthalmology, The Icahn School of Medicine at Mount Sinai, New York, New York; Department of Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York
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Shin JY, Yu HG. Intravitreal Triamcinolone Injection for Uveitic Macular Edema: A Randomized Clinical Study. Ocul Immunol Inflamm 2015; 23:430-6. [DOI: 10.3109/09273948.2015.1025982] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Karim R, Sykakis E, Lightman S, Fraser-Bell S. Interventions for the treatment of uveitic macular edema: a systematic review and meta-analysis. Clin Ophthalmol 2013; 7:1109-44. [PMID: 23807831 PMCID: PMC3685443 DOI: 10.2147/opth.s40268] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Uveitic macular edema is the major cause of reduced vision in eyes with uveitis. Objectives To assess the effectiveness of interventions in the treatment of uveitic macular edema. Search strategy Cochrane Central Register of Controlled Trials, Medline, and Embase. There were no language or data restrictions in the search for trials. The databases were last searched on December 1, 2011. Reference lists of included trials were searched. Archives of Ophthalmology, Ophthalmology, Retina, the British Journal of Ophthalmology, and the New England Journal of Medicine were searched for clinical trials and reviews. Selection criteria Participants of any age and sex with any type of uveitic macular edema were included. Early, chronic, refractory, or secondary uveitic macular edema were included. We included trials that compared any interventions of any dose and duration, including comparison with another treatment, sham treatment, or no treatment. Data collection and analysis Best-corrected visual acuity and central macular thickness were the primary outcome measures. Secondary outcome data including adverse effects were collected. Conclusion More results from randomized controlled trials with long follow-up periods are needed for interventions for uveitic macular edema to assist in determining the overall long-term benefit of different treatments. The only intervention with sufficiently robust randomized controlled trials for a meta-analysis was acetazolamide, which was shown to be ineffective in improving vision in eyes with uveitic macular edema, and is clinically now rarely used. Interventions showing promise in this disease include dexamethasone implants, immunomodulatory drugs and anti-vascular endothelial growth-factor agents. When macular edema has become refractory after multiple interventions, pars plana vitrectomy could be considered. The disease pathophysiology is uncertain and the course of disease unpredictable. As there are no clear guidelines from the literature, interventions should be tailored to the individual patient.
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Affiliation(s)
- Rushmia Karim
- Faculty of Medicine, University of Sydney, Camperdown, NSW, Australia
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Xiang-Gen W, Li-Na Y, Meng X, Hao-Ran J. Anti-Infectious Activity of Intravitreal Injectable Voriconazole Microspheres on Experimental Rabbit Fungal Endophthalmitis Caused by aspergillus fumigatus. J Pharm Sci 2011; 100:1745-59. [DOI: 10.1002/jps.22402] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Revised: 10/06/2010] [Accepted: 10/16/2010] [Indexed: 11/09/2022]
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Shen L, You Y, Sun S, Chen Y, Qu J, Cheng L. Intraocular and systemic pharmacokinetics of triamcinolone acetonide after a single 40-mg posterior subtenon application. Ophthalmology 2010; 117:2365-71. [PMID: 20678801 DOI: 10.1016/j.ophtha.2010.03.033] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2009] [Revised: 03/10/2010] [Accepted: 03/11/2010] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To characterize the pharmacokinetics of triamcinolone acetonide (TA) in aqueous, vitreous, and systemic circulation after a single subtenon injection. DESIGN Prospective interventional case series. PARTICIPANTS Thirty-six patients (36 eyes) who received a single posterior subtenon injection of TA (40 mg in 0.4 ml). METHODS Aqueous, vitreous, and blood samples were obtained at 1-hour, 1-day, 3-day, 5-day, 10-day, 14-day, 21-day, and 28-day time points after the posterior subtenon TA injection. At each time point, there were 3 to 6 eyes (patients). The concentrations of TA in the aqueous, vitreous, and plasma were analyzed using ultra-performance liquid chromatography coupled with tandem mass spectrometry. MAIN OUTCOME MEASURES Triamcinolone acetonide concentration in the samples was measured, and pharmacokinetic parameters were calculated. RESULTS The TA concentration-time profile in aqueous consisted of a fast distribution phase during the first 24 hours and a slow elimination phase thereafter. In contrast, the TA concentration-time profile in vitreous consisted of an absorption phase during the first 24 hours followed by a slow elimination phase. The TA in plasma followed a mono-exponential elimination during the study course. The TA concentration peak time for aqueous and plasma was at 1 hour and 24 hours, for vitreous after subtenon injection. The terminal elimination half-life in aqueous, vitreous, and plasma was 11.8, 17.1, and 25 days, respectively. The integral of the area under the concentration time curve (AUC(0-∞)) was 862 ng/day/ml for aqueous, 1262 ng/day/ml for vitreous, and 17.4 ng/day/ml for plasma. The total TA exposure to vitreous was 46% more than total TA exposure to the aqueous. The TA concentration in vitreous was 70- to 98-fold higher than that in plasma. CONCLUSIONS Posterior subtenon TA application can provide a sustained high local ocular TA level while also resulting in a very low systemic TA level, which may be well below the normal glucocorticoid level in humans.
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Affiliation(s)
- Lijun Shen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical College, Wenzhou, Zhejiang, China
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Oliver A, Kertes PJ. The intravitreal use of corticosteroids. EXPERT REVIEW OF OPHTHALMOLOGY 2010. [DOI: 10.1586/eop.10.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Current world literature. Curr Opin Ophthalmol 2009; 21:81-90. [PMID: 19996895 DOI: 10.1097/icu.0b013e3283350158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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