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F.C. Schlichtenbrede, J.B. Jonas; Effect and Side–Effect of Intravitreal Triamcinolone Acetonide in Various Ocular Diseases . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3856.
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© ARVO (1962-2015); The Authors (2016-present)
Intravitreal triamcinolone acetonide (IVTA) has been succesfully used in various ocular diseases.In this meta–analysis we compare effect and side–effect in different disorders of this recent therapeutic approach.
Patients and Methods: :
The case–series study included 359 eyes with diffuse diabetic macular edema (DME)(n=102), progressive exudative age–related macular degeneration with mostly non–classic subfoveal neovascularization (AMD) (n=216), uveitis (n=10), branch retinal vein occlusion (BRVO) (n=12), central retinal vein occlusion (CRVO) (n=12), and pseudophakic cystoid macular edema (csytME) (n=7). Mean follow–up was 10.6 ± 6.8 months (range, 3 to 35.7 months). Single intravitreal injections of about 20 mg triamcinolone acetonide were given. Visual acuity (VA) and intraocular pressure (IOP) were the main outcome measures.
Maximal increase in VA during follow–up was significantly lower in the AMD group (–0.10 ± 0.30 logMar units) than in the DME group (–0.24 ± 0.22 logMar units) (p<0.001), the BRVO group (–0.22 ± 0.23 logMar units) (p=0.032), the CRVO group (–0.26 ± 0.26 logMar units) (p=0.032), the uveitis group (–0.29 ± 0.19 logMar units), and the cystME (–0.30 ± 0.22 logMar units) (p=0.042). IOP rise was significantly highest in the uveitis group (11.3 ± 7.0 mm Hg), followed by the CRVO group (9.1 ± 8.7 mm Hg). There was no significant variation of IOP rise in the remaining groups. Treatment effect (VA increase > 2 lines) and IOP rise lasted for about 6 to 8 months.
Following IVTA the best increase of visual acuity was observed for intraretinal macular edema associated with non–ischemic diseases such as pseudophakic cystoid macular edema or uveitis. This effect seemed moderate in intraretinal macular edema caused by partially ischemic diseases such as diabetic macular edema. For a primarily subretinal location of the retinal changes like exudative age–related macular degeneration VA increase seemed to be lowest. IOP rise was higher in patients with uveitis than in elderly patients with age–related ocular diseases. Treatment effects of IVTA in a dosage of about 20mg lasted for 6 to 8 months and did not differ markedly between the groups.
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