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Am J Ophthalmol. 2018 Oct;194:63-71. doi: 10.1016/j.ajo.2018.07.003. Epub 2018 Jul 24.

Treatment Duration and Side Effect Profile of Long-Term Use of Intravitreal Preservative-Free Triamcinolone Acetonide in Uveitis.

Author information

1
Duke Eye Center, Duke University, Durham, North Carolina, USA.
2
Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
3
Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA.
4
Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA. Electronic address: srivass2@ccf.org.

Abstract

PURPOSE:

Noninfectious uveitis has been treated historically with corticosteroid therapy in varying doses and routes. Triesence, a preservative-free sterile formulation of triamcinolone acetonide, has been used in a wide spectrum of ocular pathologies, but there have been few large studies validating its dosing or detailing long-term side effects in uveitic disease. The primary aim of this study was to describe the relative duration of action and side effects of 2 doses of preservative-free intravitreal triamcinolone acetonide (PF-IVTA) in uveitis.

DESIGN:

Retrospective, comparative consecutive case series.

METHODS:

Charts of all patients receiving PF-IVTA (2 mg or 4 mg) in a defined time period (2012-2014) at the Cole Eye Institute were examined for patient demographics, time to treatment failure (TTF), use of systemic immunosuppression, use of intraocular pressure-lowering therapies, date of cataract surgery and glaucoma filtration surgery, and adverse events.

RESULTS:

The final data set examined 514 injections in 214 eyes. Mean duration of follow-up was 1.5 years. There was similar demographic distribution between eyes that received 2 mg PF-IVTA only and eyes that received a combination of 4 + 2 mg PF-IVTA. No statistically significant difference in TTF between injection dosages was observed. There was a higher incidence of glaucoma filtering surgery and cataract surgery in eyes that received 4 + 2 mg PF-IVTA as well as a shorter time to glaucoma surgery, when compared to eyes that received 2 mg PF-IVTA alone.

CONCLUSIONS:

This retrospective study supports that 2 mg PF-IVTA displayed noninferior treatment duration to 4 mg PF-IVTA, and may carry a significantly lower side-effect profile of cataract development and glaucoma filtering surgery.

PMID:
30053470
DOI:
10.1016/j.ajo.2018.07.003
[Indexed for MEDLINE]

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