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Preethi S Ganapathy, Chris Donovan, Kimberly Baynes, Rishi Singh, Careen Y Lowder, Sunil K Srivastava; Effectiveness and safety profile of long-term use of triamcinolone acetonide (Triesence®) in ocular disease.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4515.
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© ARVO (1962-2015); The Authors (2016-present)
Non-infectious uveitis has historically been treated with steroid therapy in varying doses and routes. Triesence®, a sterile formulation of triamcinolone acetonide without benzyl alcohol preservative, has been used in a wide spectrum of ocular pathologies including uveitis and macular edema from diabetes or vascular occlusion, but there have been very few large studies comparing dosing or detailing specific long-term side-effects with this formulation.
The charts of all patients who received intravitreal injections of Triesence® (2mg or 4mg) in a defined time period (2012-2014) at the Cole Eye Institute were reviewed. Patients with less than 3 months follow-up were excluded. Variables including diagnosis, injection laterality, dosage, number of injections over 1 year, Snellen visual acuity, intraocular pressure, central macular thickness, initiation of pressure lowering medication, time to cataract surgery or glaucoma filtering surgery, and incidence of endophthalmitis were tabulated and analyzed.
278 total patients received intravitreal injections in the study period. Preliminary data using the first 100 patients were analyzed for adverse events. Of these, 30 patients were excluded as per study criteria. The follow-up period was 1 year or greater in 49 patients. At 3 months, 13 (18.6%) required initiation of an average of 1.18 pressure-lowering medications; at 1 year, 7 (14.3%) required an average of 1.43 medications. Incidence of cataract extraction was 32.7% of all phakic patients, and time to surgery after first Triesence® injection was 311.93 days. Incidence of glaucoma filtering surgery was 2.9%, and time to surgery was 434.5 days. One subject required exchange of a previously placed glaucoma implant. One subject developed a sterile inflammatory reaction to injection; diagnostic vitrectomy revealed no causative organisms.
This study will provide the most extensive analysis of effective dosing of intravitreal injections of Triesence® in various ocular conditions, and will catalogue the array of long-term side effects produced at varying doses. Preliminary data indicate that long-term use of intraocular Triesence® carries a low risk of adverse events, and that cataract development and intraocular pressure increase are the primary complications of treatment.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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