The Pros and Cons of Intravitreal Triamcinolone Injections for Uveitis and Inflammatory Cystoid Macular Edema |
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Authors: | Bram van Kooij Aniki Rothova Philip de Vries |
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Affiliation: | 1. F.C. Donders Institute of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands;2. Department of Pharmacy, University Medical Center Utrecht, Utrecht, The Netherlands |
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Abstract: | Intravitreal triamcinolone acetonide (IVTA) injections are gaining in popularity and are regularly administered nowadays for various ocular diseases. This paper presents a literature review on the use, efficacy, and complications of IVTA application in non-infectious uveitis and inflammatory cystoid macular edema (CME). In addition, we describe the experiences of our own institute. IVTA applications brought about a quick improvement in vision in the majority of cases. Drawbacks included the temporary duration of the effect with the need for repeated injections which re-exposed patients to the risk of complications. The risk of bacterial endophthalmitis was 0.5% and was further influenced by the specific IVTA preparation. Based on the literature review, we chose ready-for-use IVTA injections prepared by our pharmacy department, in which 90% of the toxic additives were removed and the dispensed dose of triamcinolone acetonide was validated to diminish the risk of endophthalmitis. Elevated intraocular pressure (IOP) was seen in 30–43% of the eyes and cataract developed in 29% of the eyes of patients, who were usually of advanced age. In conclusion, the rapid effect of IVTA might be of value in severe presentations of non-infectious uveitis and CME and might shorten the time interval needed for the improvement. |
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Keywords: | Intravitreal triamcinolone acetonide uveitis inflammatory cystoid macular edema endophthalmitis cataract elevated interocular pressure |
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