[Intravitreal triamcinolone acetonide for the treatment of intraocular edematous and neovascular diseases].
BACKGROUND
Within the last 2 years, intravitreal application of triamcinolone acetonide has exponentially increased as a treatment option for various intraocular neovascular and edematous proliferative disorders.


RESULTS
The best response to intravitreal triamcinolone acetonide injection in terms of gain in visual acuity was obtained for eyes with intraretinal edematous diseases such as diffuse diabetic macular edema, branch retinal vein occlusion, central retinal vein occlusion, and pseudophakic cystoid macular edema. Visual acuity increased and degree of intraocular inflammation decreased in eyes with various types of noninfectious uveitis including sympathetic ophthalmia. Intravitreal triamcinolone may be useful as angiostatic therapy in eyes with iris neovascularization and proliferative ischemic retinopathies. Possibly, intravitreal triamcinolone may be helpful for exudative age-related macular degeneration, alone or in combination with photodynamic therapy. In eyes with chronic, therapy-resistant, ocular hypotony, intravitreal triamcinolone can induce an increase in intraocular pressure and may stabilize the eye. The complications of intravitreal triamcinolone therapy, such as secondary ocular hypertension in about 40% of the eyes injected, cataractogenesis, postoperative infectious and noninfectious endophthalmitis, and pseudo-endophthalmitis will be covered in another article. Intravitreal triamcinolone injection can be combined with other intraocular surgeries including cataract surgery. Cataract surgery performed some months after the injection did not show a markedly elevated rate of complications. If vision increases after the intravitreal triamcinolone injection, the injection can be repeated. The duration of the effect of a single intravitreal injection of triamcinolone ranges between 2 and 9 months, probably depending on the dosage used.


CONCLUSIONS
Intravitreal triamcinolone acetonide may offer a possibility for adjunctive treatment of intraocular oedematous and neovascular disorders. One has to take into account the side effects and the lack of long-term follow-up observations.
Fakultät für Klinische Medizin Mannheim der Ruprecht-Karls-Universität, Universitäts-Augenklinik, Heidelberg. Jost.Jonas@augen.ma.uni-heidelberg.de
J B
JB
Jonas
I
I
Kreissig
B
B
Kamppeter
R F
RF
Degenring
D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D003131:Combined Modality Therapy; D003930:Diabetic Retinopathy / Q000188:drug therapy; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007267:Injections; D007429:Intraocular Pressure; D007499:Iris Diseases / Q000188:drug therapy*; D008268:Macular Degeneration / Q000188:drug therapy*; D008269:Macular Edema / Q000188:drug therapy; D015814:Ocular Hypotension; D009879:Ophthalmia, Sympathetic / Q000188:drug therapy*; D010211:Papilledema / Q000188:drug therapy; D010778:Photochemotherapy; D012164:Retinal Diseases / Q000188:drug therapy*; D015861:Retinal Neovascularization / Q000188:drug therapy; D012170:Retinal Vein Occlusion / Q000188:drug therapy; D013997:Time Factors; D014222:Triamcinolone Acetonide / Q000008:administration & dosage* / Q000009:adverse effects; D014605:Uveitis / Q000188:drug therapy*; D014792:Visual Acuity; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D014222:Triamcinolone Acetonide