Evaluation of intravitreal kenalog toxicity in humans.
OBJECTIVE
To evaluate possible functional toxicity of intravitreal Kenalog (commercial triamcinolone acetonide) in patients' retinas.


METHODS
Observational case series.


METHODS
Thirty-two phakic eyes of 16 patients who had nonproliferative diabetic retinopathy and bilateral macular edema refractory to laser therapy, which had no other eye disorder and no previous ophthalmic operation.


METHODS
Kenalog (4 mg/0.1 ml) was injected intravitreally to one eye, whereas the second eye served as the control. The experimental eye was chosen as the eye with worse visual acuity (VA).


METHODS
Deterioration of electroretinogram parameters of the study eye measured at 3 months of follow-up when compared with the electroretinogram responses of the fellow, control eye and when compared with electroretinogram responses obtained before injection. Visual acuity, intraocular pressure (IOP), and eventual complications were assessed. No improvement or deterioration of VA or any increase in IOP was regarded as a secondary outcome.


RESULTS
Average maximal response amplitude ratios of the dark-adapted b-wave (treated/control eyes) of the electroretinogram were 0.93 before (P = 0.221) and 0.94 (P = 0.387) 3 months after Kenalog injection. Average ratios of the light-adapted b-wave amplitude (treated/control eyes) of the electroretinogram were 1.04 (P = 0.702) before and 0.86 (P = 0.138) 3 months after Kenalog injection. No significant differences (P>0.05) were found between the electroretinogram parameters obtained from all eyes before and 3 months after Kenalog injection. Average VAs in the treated eyes were 1.08, 0.8, and 1.0 logarithm of the minimum angle of resolution units before and 2 and 4 months after injection, respectively. Temporary elevation of IOP was found in 4 treated eyes of 4 patients (25%).


CONCLUSIONS
No electroretinographic evidence of a retinotoxic effect of intravitreal Kenalog was found in our patients.
Lang
Yaron
Y
Department of Ophthalmology, Ha'Emek Medical Center, Afula, Israel. ylang@012.net.il
Leibu
Rina
R
Shoham
Nir
N
Miller
Benjamin
B
Perlman
Ido
I
D000328:Adult; D000368:Aged; D003623:Dark Adaptation; D003930:Diabetic Retinopathy / Q000188:drug therapy / Q000503:physiopathology; D004341:Drug Evaluation; D004596:Electroretinography / Q000187:drug effects*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000633:toxicity*; D006801:Humans; D007267:Injections; D007429:Intraocular Pressure; D008269:Macular Edema / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012160:Retina / Q000187:drug effects* / Q000503:physiopathology; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000633:toxicity*; D014792:Visual Acuity; D014822:Vitreous Body
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide