Intravitreal Injections of 4 mg and 20 mg Triamcinolone Acetonide in the Treatment of Diabetic Macular Edema: Comparison of Efficacy and Side Effects

Background: Diabetic macular edema (DME) is the main cause of visual impairment in diabetic retinopathy (DR). Current gold standard therapy of DME is macular laser photocoagulation (MPC). Growing evidences have shown benefits of intravitreal anti-VEGF agents (i.e bevacizumab) and intravitreal corticosteroids (i.e triamcinolone acetonide). Aim: To compare the visual acuity (VA) improvement of patients with DME, treated with intravitreal bevacizumab (IVB), a combination of IVB and intravitreal triamcinolone (IVB/IVT), and MPC. Method: A comprehensive PubMed® and Cochrane® databases search was conducted on May 4th, 2017 using appropriate keywords (diabetic macular edema, bevacizumab, triamcinolone, and laser photocoagulation using their MeSH terms). Studies were filtered using inclusion criterions (clinical trials, RCT, meta-analysis, systematic review, English, humans, and publication within 10 years) Results: Three studies (2 systematic reviews and 1 RCT) were found suitable. From these results, all studies showed favoring effects of IVB when compared to IVB/IVT combination and MPC in short term period (up to 6 months). However, there was no significant improvement of VA beyond this period in all groups. Conclusion: IVB appears to be superior to IVB/IVT and MPC in improving VA during 6 months follow- up period. Future systematic reviews and meta-analysis are required on the effect of IVB and MPC combination in cases of DME.

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Comparison of Intravitreal versus Posterior Sub–Tenon’s Capsule Injection of Triamcinolone Acetonide for Diffuse Diabetic Macular Edema

Ophthalmology ◽

10.1016/j.ophtha.2005.03.023 ◽

2005 ◽

Vol 112 (9) ◽

pp. 1557-1563 ◽

Cited By ~ 88

Author(s):

José A. Cardillo ◽

Luiz A.S. Melo ◽

Rogério A. Costa ◽

Mirian Skaf ◽

Rubens Belfort ◽

...

Keyword(s):

Macular Edema ◽

Triamcinolone Acetonide ◽

Diabetic Macular Edema ◽

Tenon’S Capsule ◽

Diffuse Diabetic Macular Edema ◽

Tenon's Capsule

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EFFICACY OF COMBINED INTRAVITREAL INJECTIONS OF BEVACIZUMAB AND TRIAMCINOLONE ACETONIDE IN PATIENTS WITH NON-RESOLVING MACULAR EDEMA SECONDARY TO BRANCH RETINAL VEIN OCCLUSION

10.36106/ijar/6801974 ◽

2021 ◽

pp. 48-49

Author(s):

Haniyaa Mufti ◽

Syed Tariq Qureshi ◽

Birjees Hakak

Keyword(s):

Combination Therapy ◽

Macular Edema ◽

Triamcinolone Acetonide ◽

Retinal Vein Occlusion ◽

Branch Retinal Vein Occlusion ◽

Common Adverse Effect ◽

Visual Outcome ◽

Intravitreal Injections ◽

Therapeutic Effects ◽

Vein Occlusion

Purpose: To study the effects of combined intravitreal injections of bevacizumab (IVB) and triamcinolone acetonide (IVTA) in patients with non-resolving macular edema (ME) secondary to Branch Retinal Vein Occlusion (BRVO). Methods: In a prospective observational study, 50 pseudophakic eyes of BRVO patients with non-resolving central macular edema who had received more than 3 doses of IVB previously were injected with combination therapy of 1.25 mg/0.05 ml IVB and 4 mg of IVTA and followed up for 6 months with best corrected visual acuity(BCVA), intraocular pressure(IOP) and central macular thickness(CMT) Results: The mean BCVA was logMAR 0.75±0.25 at baseline and 0.65±0.15, 0.48±0.20, and 0.22±0.25 at 6weeks, 3 months and 6 months respectively. Mean CMT at baseline was 668.32±254.66 and 434.43±99.55, 243.22±58.92, and 220.83±42.60 at 6 weeks, 3 months and 6 months respectively. Baseline IOP measured was 16.5±3.1 mmHg which progressed to 19.6±3.4mmHg and 21.4±2.8mmHg at 6 weeks and 3 months respectively and decreased to 17.3±2.2 at 6 months. The most common adverse effect seen was increase in IOP in 24(48%)patients, out of which 3(6%) patients needed to start anti-glaucoma medication (AGM). 3(6%) patients had sub-conjunctival hemorrhage(SCH). Conclusion: The prolonged therapeutic effects of combination therapy leads to outstanding anatomical and visual outcome in non resolving ME due to BRVO, with fewer doses and thus fewer adverse effects.

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EFFICACY OF INTRAVITREAL TRIAMCINOLONE ACETONIDE FOR DIABETIC MACULAR EDEMA

Journal of Universal College of Medical Sciences ◽

10.3126/jucms.v3i2.14288 ◽

2016 ◽

Vol 3 (2) ◽

pp. 30-34

Author(s):

Prachand Gautam ◽

Koshal Shrestha ◽

Gyanendra Lamichhane ◽

Sushila Patel

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Macular Edema ◽

Triamcinolone Acetonide ◽

Diabetic Macular Edema ◽

Intravitreal Triamcinolone ◽

Hard Exudates ◽

Intravitreal Triamcinolone Acetonide ◽

Diffuse Diabetic Macular Edema

INTRODUCTION: Diabetic retionopathy is a microangilpathy. The present study was done to investigate results of Intravitreal Triamcinolone Acetonide injection for the treatment diffuse diabetic macular edema. MATERIAL AND METHODS: The study included 40 eyes of 40 patients with clinically significant diffuse diabetic macular edema. Eyes were diagnosed with diabetic macular edema according to Early Treatment Diabetic Retinopathy Study guidelines. An Intravitreal injection of Triamcinolone Acetonide at the dose of 4 mg/0.2 ml was administered. Best corrected visual acuity was measured as the logarithm of the minimum angle of resolution (logMAR) and snellen vision drum and size of macular edema (hard exudates) was obtained by slit lamp biomicroscopy using +90 D Volk lens at each visit. Intraocular pressure (IOP) and other complications related with steroid and injection related complications were also evaluated. Subsequently patients were followed up on 1st day, 2nd week and 3rd month. RESULTS: All patients were completed second follow up at 3 months. The mean size of macular edema, which obtained at 3 months postoperatively, was significantly different from the baseline measurement from 1.4125 to 0.9474 DD. Mean visual acuity improved significantly from baseline at 3 months of follow up was 0.7421 LogMAR (≈ 6/30 in Snellen chart). Eleven eyes developed intraocular pressure higher than 21 mmHg at 2nd week postoperatively. Other drug and injection related complications were not developed. Increased IOP were controlled with anti glaucoma drugs. CONCLUSIONS: Intravitreal Triamcinolone was a promising therapeutic method for diabetic macular edema. TriamcinoloneAcetonide effectively reduces size of macular edema and improves visual acuity in the short term.Journal of Universal College of Medical Sciences (2015) Vol.03 No.02 Issue 10 Page: 30-34

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