[Ocular side effects and complications of intravitreal triamcinolone acetonide injection].
With the advent of intravitreal triamcinolone acetonid injections major focus was assigned to potential ocular side effects. The current discussion is dominated by the potential cytotoxicity of particular biologically incompatible components. Those are regarded as substantial pathogenetic factor of the sterile pseudoendophthalmitis that seems to be avoidable by meticulous purification of the commercially available preparations. Even sustained subretinal or epiretinal deposits disclosed no signs of retinal toxicity. Major ocular side effects comprise temporary corticosteroid glaucoma and progressive cataract formation. Infectious endophthalmitis represents a rare but serious complication that might be set into critical context with hygienic surgical standards applied. Due to steroid-induced immune suppression clinical signs of inflammation might be masked and a proper diagnosis delayed. Other rare complications reported include a transient central retinal artery occlusion, conjunctival ulcerations, retinal detachment and potential reactivation of a cytomegalovirus retinitis. In conclusion, ocular side effects and complications show a wide variety of clinical signs and underlying causal mechanisms. However, the consequences are mostly temporary and show a good response to therapeutic intervention.
Jaissle
G B
GB
Abteilung für Erkrankungen des vorderen und hinteren Augenabschnitts, Universitäts-Augenklinik, Tuebingen. g.jaissle@gmx.de
Szurman
P
P
Bartz-Schmidt
K U
KU
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002386:Cataract / Q000139:chemically induced; D003229:Conjunctival Diseases / Q000139:chemically induced; D018849:Controlled Clinical Trials as Topic; D009877:Endophthalmitis / Q000139:chemically induced; D005128:Eye Diseases / Q000139:chemically induced*; D005901:Glaucoma / Q000139:chemically induced; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D007267:Injections; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D012160:Retina / Q000187:drug effects; D015356:Retinal Artery Occlusion / Q000139:chemically induced; D012163:Retinal Detachment / Q000139:chemically induced; D012189:Retrospective Studies; D013997:Time Factors; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000009:adverse effects*; D014456:Ulcer / Q000139:chemically induced; D014822:Vitreous Body
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D014222:Triamcinolone Acetonide