Effect of Supra-Choroidal Triamcinolone Injection on Best-Corrected Visual Acuity and Central Retinal Thickness in Patients with Macular Edema Secondary to Retinal Vein Occlusion

Purpose: To find out the effect of suprachoroidal Triamcinolone injection on best corrected visual acuity (BCVA) and central retinal thickness (CRT) in patients with macular edema secondary to retinal vein occlusion. Study Design: Interventional case series. Place and Duration of Study: College of Ophthalmology and Allied vision Sciences, Ophthalmology department, Unit II Mayo hospital, Lahore, from September 2019 to January 2020. Methods: This study included 45 patients diagnosed with unilateral, retinal vein occlusion associated with macular edema. Patients with previous anti-vascular endothelial growth factor injection or any steroid injection received in the last 3 months or macular edema due to any other cause were excluded from the study. Only one eye of each patient was enrolled. The patients were treated with suprachoroidal triamcinolone injection (4 mg/100µL concentration). Patients with baseline central retinal thickness (CRT) of > 300 µm were included in the study. Serial changes in this parameter were evaluated at 1 week, 1 month and 3?months after suprachoroidal triamcinolone injection. Final CRT and Best-corrected visual acuity (BCVA) was recorded after three months. Results: Out of 45 patients, 26 (57.7%) were males and 19 (42.2%) were females. Majority of the patients (35.4%) were 51–60 years old. During first week the visual acuity was 0.321 ± 0.273 LogMAR, after one month it was 0.468 ± 0.291 and 0.406 ± 0.318 after 03 months with a p value of 0.003. After three months significant decrease in CRT was observed. With a p-value of 0.002. Conclusions: Suprachoroidal injection significantly improves BCVA and decreases CRT in patients with macular edema due to retinal vein Occlusion. Keywords: Retinal vein occlusion, suprachoroidal injection, triamcinolone acetonide.

Efficacy of Subtenon 20-mg Triamcinolone Injection Versus 0.1% Dexamethasone Eye Drops For Controlling Inflammation After Phacoemulsification: A Randomized Controlled Trial

A prospective randomized control trial of 140 eyes from 140 patients, who underwent phacoemulsification, was conducted to compare the efficacy of subtenon corticosteroids injection with corticosteroids eye drops for controlling postoperative intraocular inflammation. Seventy patients received subtenon 20-mg triamcinolone injection (TA group), whereas the other 70 patients received 0.1% dexamethasone eye drops (Dexa group) after the uneventful surgeries. We examined and measured anterior chamber inflammation (ACI) score, laser flare-cell metering, conjunctival redness, pain, discomfort, visual acuity, intraocular pressure, and central foveal thickness on 1, 7, 14, 28 and 90 days postoperatively. At one month after the surgery, full recovery (zero ACI score) was found in 43 patients (63.20%) in the Dexa group versus 47 patients (68.10%) in the TA group (p=0.55). There were no statistically differences in aqueous cells (p=0.37) and flare (p=0.86) between the two groups at one month. All participants experienced no serious adverse events. In conclusion, we found no statistically significant difference between subtenon 20-mg triamcinolone injection and 0.1% dexamethasone eye drop to control inflammation postoperatively. A single subtenon 20-mg triamcinolone injection could be an alternative anti-inflammatory treatment for an uneventful phacoemulsification.

Efficacy of Supratarsal Triamcinolone Injection versus Dexamethasone in Recalcitrant Vernal Keratoconjunctivitis

Aim: To determine the effectiveness of supratarsal triamcinolone injection versus dexamethasone in recalcitrant vernal keratoconjunctivitis. Study Design: Prospective/randomized study Place and Duration of Study: Department of Ophthalmology, Lorallai Medical College, Loralai from 1st October 2020 to 31st March 2021. Methods: Fifty patients (100 eyes) of both genders and age between 12-40 years were enrolled. Detailed demographics of enrolled cases age, sex and body mass index were recorded after taking informed written consent. All patients had recalcitrant vernal keratoconjunctivitis. Patients were equally divided into 2-groups. Group I had 25 patients and received 20mg of supratarsal triamcinolone injection in both eyes and group II with 25 patients received 2mg of dexamethasone in their eyes. Postoperative effectiveness, complications and recurrence of disease was observed and compared among both groups. Results: There were 15 (60%) males and 10 (40%) females in group I with mean age 18.14±6.34 years while in group II, 15 (60%) males and 10 (40%) females with mean age was 17.68±4.54 years. Palprebral vernal keratoconjunctivitis was found in 36 eyes (10 patients of group I and 8 patients of group II) and Mixed vernal keratoconjunctivitis in 64 eyes (15 patients of group I and 17 patients of group II). Symptoms were itching,photophobia, lacrimation and pain. Conjunctival hyperemia, giant papillae and limbal infiltrate were the most common signs observed. Post operatively effectiveness among group I and II was (100% vs 92%) without any complication. Recurrence rate of vernal keratoconjunctivitis in group I was lower 4% as compared to group II 10%. Conclusion: The use of supratarsal triamcinolone injection in patients of recalcitrant vernal keratoconjunctivitis was effective and safest method as compared to dexamethasone in terms of less recurrence and high rate of efficacy. Keywords: Supratarsal triamcinolone, Dexamethasone, Vernal keratoconjunctivitis, Effectiveness, Recurrence

Use of Triamcinolone in keloid

<p class="abstract"><strong>Background:</strong> Keloids are well known for recurrence. There is no standardized regimen for the treatment of keloids. Many different treatment modalities such as surgical excision, intralesional corticosteroids, radiotherapy, and pressure earrings have been used for keloids. Surgical excision alone may result in recurrence rate of 40-100%. Many different modalities of treatment have been tried to prevent recurrence. Aims and objectives of the study was to evaluate the efficacy of Triamcinolone in preventing recurrence of Keloid.</p><p class="abstract"><strong>Methods: </strong>40 patients who underwent excision of keloid at a tertiary care centre. Surgery alone was performed in 20 patients and surgery with post operative intra lesional Triamcinolone injection was given weekly interval for 6 weeks in another 20 patients. Patients were followed up for the period of 2 years</p><p class="abstract"><strong>Results: </strong>Recurrence was found in 5 patients who underwent excision alone and there was no recurrence among patients who received post operative intra lesional triamcinolone.</p><p class="abstract"><strong>Conclusions: </strong>Multi modality treatment is better to prevent recurrence of Keloid.</p>