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F. Menchini, P. Lanzetta, A. Polito, D. Roman Pognuz, L. Peressin, A. Papaianis, L. Morgante, F. Bandello; Posterior Juxtascleral Infusion of a New Formulation of Triamcinolone Acetonide for the Treatment of Macular Edema Due to Different Ethiology . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3842.
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© ARVO (1962-2015); The Authors (2016-present)
To prospectively evaluate the efficacy of posterior juxtascleral infusion of a new formulation of Triamcinolone Acetonide (TA) on visual acuity and macular thickness using optical coherence tomography (OCT) in macular edema associated with various retinal disorders.
This clinical interventional study included 12 eyes (12 patients) with refractory diffuse diabetic macular edema (DME), 5 eyes (5 patients) with persistent macular edema (ME) after macular pucker surgery, 5 eyes (5 patients) with ME associated with choroidal neovascularization (CNV) secondary to age related macular degeneration (AMD). To control reflux during the administration, 40 mg of TA were mixed with 20 mg sodium chondroitin sulphate and 15 mg sodium hyaluronate (1.5 ml). The suspension was delivered posteriorly throught a small conjunctival and Tenon's incision, using a curved blunt cannula. PDT was performed one week after the juxtascleral infusion in eyes with CNV. Main outcome measures were the change in central macular thickness (CMT) measured by optical coherence tomography (OCT), the change in visual acuity, the variations in intraocular pressure (IOP) and the progression of cataract.
Mean follow–up was 4.1+/–1.65 weeks. Mean visual acuity (VA) increased from 0.75+/–0.38, 0.5+/–0.41 and 0.8+/–0.43 logMAR in eyes with refractory diffuse DME, ME following macular pucker surgery and ME associated with CNV, respectively, to 0.58+/–0.27, 0.43+/–0.4 and 0.74+/–0.51 logMAR at 3 months. Mean CMT decreased by 36.9 %, 33.2 % and 20.7 % in all three groups of pathologies at 3 months, respectively. In eyes with refractory DME, four of six eyes developed a recurrence of DME with worsening of VA at 6 months follow–up. Intraocular pressure exceeded 21 mmHg in 8 eyes and it was controlled by topical medications. No cataract progression was observed.
A single juxtascleral infusion of a new formulation of Triamcinolone Acetonide led to a decrease of CMT and an improvement of VA in patients with ME due to different ethiology. However the effect was not permanent and it lasted over a short period.
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