Effect Of Triamcinolone Acetonide Research Articles

Triamcinolone acetonide suppressed scar formation in mice and human hypertrophic scar fibroblasts in a dose-dependent manner.

A hypertrophic scar is a complex medical problem. The study of triamcinolone acetonide for the treatment of scars is necessary. The 7mm full-thickness skin wounds were created on the back of BALA/c mice to construct the animal scar model. The different doses of triamcinolone acetonide injection or normal saline were injected into the wound on the 15th, 30th and 45th day after the operation. The skin histopathological changes of mice were observed by Hematoxylin-Eosin (H&E) staining. The proteins and mRNA expression level of scar-biomarkers (COL1, COL3, α-SMA) in mice scar tissue were detected by western blot and qRT-PCR. Besides, the effect of triamcinolone acetonide on the proliferation, invasion, and migration of human hypertrophic scar fibroblast (hHSFs) in vitro was also explored by cck-8, transwell and wound healing assays. After triamcinolone acetonide was injected into the wound, the proportion of scar was significantly reduced, and the treatment effect was concentration-dependently. H&E staining showed that the skin histopathological of mice was improved dose-dependently after injecting the low/middle/high-dosage of triamcinolone acetonide. The proteins and mRNA expression levels of COL1, COL3, and α-SMA were reduced dose-dependently in mice scar tissue. Furthermore, triamcinolone acetonide dose-dependently suppressed the proliferation, invasion, and migration of hHSFs in vitro. Together, triamcinolone acetonide suppressed scar formation in mice and human hypertrophic scar fibroblasts in a dose-dependent manner, phenotypically and mechanistically. The research and further exploration of triamcinolone acetonide in treating scar formation may find new effective treatment methods for the scar.

Effect of triamcinolone acetonide on retinal inflammation and angiogenesis induced by pericyte depletion in mouse

Triamcinolone acetonide (TA) has been shown to improve morphological and functional outcome in diabetic macular edema (DME) patients. However, the functional mechanism of TA has not been elucidated yet. In this study we investigated the detailed functional mechanism of TA using culture cells and retinopathy mouse models in which retinal inflammation and abnormal angiogenesis were induced by pericyte depletion. TA significantly prevented retinal hemorrhage, edema and partially improved abnormal angiogenesis. TA decreased retinal vascular endothelial growth factor (VEGF) concentration, presumably by preventing recruitment of macrophages into retina and TA also inhibited expression of inflammatory cytokines in retina. TA inhibited proliferation/migration of vascular endothelial cells and vessel sprouting. No direct inhibition of VEGF receptor 2 (VEGFR2) autophosphorylation was observed by TA. These results suggested that TA improved inflammatory retinal events which were induced in pericyte-deleted mice by mainly decreasing macrophage-derived VEGF and expression of inflammatory cytokines followed by attenuation of vascular permeability and proliferation/migration of endothelial cells. Furthermore, in these processes, translocation of glucocorticoid receptor (GR) was partially involved.

Comparing the Efficacy and Safety of Intralesional Verapamil With Intralesional Triamcinolone Acetonide in Treatment of Hypertrophic Scars and Keloids: A Meta-Analysis of Randomized Controlled Trials

Clinical treatment of hypertrophic scars (HSs) and keloids is often unsatisfactory. Intralesional injections of triamcinolone acetonide (TAC) and verapamil are widely used to treat HSs and keloids, but their efficacy and safety are controversial. The aim of this study was to conduct a meta-analysis of the effectiveness and safety of verapamil and TAC in the treatment of HSs and keloids. Embase, Google Scholar, and PubMed were searched for randomized controlled trials (RCTs) from inception to February 2020. RCTs that evaluated treatment effects with the Vancouver Scar Scale or reported adverse effects were included. The continuous data and the dichotomous variables were analyzed as mean difference (MD) and relative risk (RR), respectively. Seven RCTs (461 patients) were included. Compared with verapamil, TAC rapidly changed the ∆height (MD = 0.07; P < 0.05) and ∆pliability (MD = 0.23; P < 0.05) after the first session, but subsequent treatments resulted in no significant differences in the ∆height, ∆pigmentation, ∆vascularity, and ∆pliability. Although total adverse effects (RR = 0.42; P = 0.1) were not significantly different, in the subgroup analysis the incidence of telangiectasia (RR = 0.04; P < 0.05) and skin atrophy (RR = 0.10; P < 0.05), but not pain (RR = 1.27; P = 0.77), was significantly lower with verapamil than with TAC. Verapamil may be an effective substitute for TAC. Although total adverse effects did not change, the incidence of telangiectasia and skin atrophy was lower with verapamil than with TAC.

Therapeutic Effects of Intranasal Tofacitinib on Chronic Rhinosinusitis with Nasal Polyps in Mice.

The Janus kinase/signal transducer and activator of transcription (JAK-STAT) pathway play a key role in immune modulation, especially in the polarization of T helper cells. JAK inhibitors reduce inflammation by inhibiting the phosphorylation of STAT. We investigated whether a JAK inhibitor, tofacitinib, can reduce inflammation in a mouse model of chronic rhinosinusitis with nasal polyps (CRSwNP). An eosinophilic CRSwNP model was induced using 4-week-old BALB/c mice. The therapeutic effects of topical tofacitinib were compared with the effects of triamcinolone acetonide (TAC). Polyp formation and eosinophilic infiltration were assessed by histology. Levels of phosphorylated STAT (pSTAT), eosinophil cationic protein, and eotaxin were measured by immunohistochemistry. Gene expression levels of GATA-3 was measured using quantitative PCR. The production of cytokines in sinonasal tissues, including interleukin IL-4, IL-5, IL-12, and interferon-γ, were measured using enzyme-linked immunosorbent assays (ELISA). Topical tofacitinib administration significantly reduced the number of polyp-like lesions and the degree of eosinophilic infiltration, with an efficacy comparable with that of systemic TAC administration. Similarly, the levels of pSTAT6, eosinophil cationic protein, and eotaxin decreased with tofacitinib treatment. Tofacitinib decreased the gene expression level of GATA-3. Lastly, tofacitinib significantly decreased IL-4 and IL-5 production to a similar extent as that by systemic or topical TAC administration. Tofacitinib, but not TAC, significantly increased the production of interferon-γ. Topical tofacitinib administration may be an effective treatment for eosinophilic CRSwNP by inhibiting phosphorylation of STATs. N/A. Laryngoscope, 131:E1400-E1407, 2021.

Outcome of triamcinolone acetonide injection for lateral malleolar bursitis.

This study aimed to evaluate the feasibility and effect of triamcinolone acetonide (TA) injection for lateral malleolar (LM) bursitis. We retrospectively reviewed data of 49 consecutive patients (49 ankles) who received TA injection between March 2016 and March 2019. All cases received 1 ml (40 mg) of TA injection after aspiration of fluid in the LM bursal sac. Subsequently, the ankle was compressed with an elastic cohesive bandage for 2 weeks. Treatment responses were assessed according to the degree of fluctuation, shrinkage of the bursal sac, and soft tissue swelling. We used the Medical Outcomes Study Short Form Health Survey (SF-36) and complications at 2 and 4 weeks and at 3 and 6 months after TA injection. Forty-four patients (89.8%) experienced complete resolution, four (8.2%) had partial resolution, and one (2.0%) had no resolution after the first or second TA injection. The physical component scores of SF-36 improved from 72.8 ± 6.0 to 82.3 ± 6.5 at the last follow-up (p < 0.001). Associated complications included skin atrophy in three patients (6.1%) and transient hyperglycemia in four (8.2%). TA injection is an effective and safe procedure for LM bursitis. It should be considered as a primary treatment method.

Effect of triamcinolone acetonide on stiffness after surgical treatment of proximal humerus fractures: a randomized controlled study.

The primary aim of this study was to determine the effectiveness and safety of an intraarticular triamcinolone injection for the treatment of stiffness after the operative treatment of proximal humerus fractures. 88 patients who underwent plate fixation for proximal humerus fractures were enrolled. The patients were randomly divided into two groups, with Group I receiving a glenohumeral injection of triamcinolone 8weeks postoperatively and Group II receiving no injection postoperatively. Outcomes were measured and compared based on the range of motion (ROM) and functional scores. Follow-up outcomes were assessed at initial, 3, 6 and 12months postoperatively and at the last follow-up. Shoulder trauma series were taken at every visit to evaluate the fracture healing. The mean follow-up period was 25.37 (± 3.85) months Group I and 24.24 (± 6.23) months for group II. In both groups, the final outcome of the ROM and functional outcome was significantly better at last F/U than at postoperative 8weeks. Group I had significantly better results than Group II at postoperative 3 and 6month in terms of forward flexion, external rotation, and VAS for pain. Also, Group I showed better performance in terms of ASES and Constant score at postoperative 3months. The fracture union rate did not differ between Groups I and II. Postoperative glenohumeral injection of triamcinolone is a safe and effective treatment modality for shoulder stiffness after internal fixation of proximal humerus fractures during the early period of rehabilitation.

Triamcinolone acetonide combined with aminoguanidine inhibits inflammation and oxidative stress, improves vascular endothelial and retinal function and reduces VEGF expression in diabetic retinopathy patients.

Effects of triamcinolone acetonide (TA) combined with aminoguanidine (AG) on vascular endothelial function, vascular endothelial growth factor (VEGF) expression and retinal function in diabetic retinopathy (DR) patients were studied. A total of 100 patients with DR admitted to the Taizhou Second People's Hospital Affiliated to Yangzhou University from January 2016 to December 2018 were collected and randomly divided into observation group (n=50) and control group (n=50). The control group was only treated with TA (4 mg), while the observation group was additionally treated with AG (50 mg/kg). The therapeutic effect and adverse reactions were observed, and the changes in blood glucose (GLU), blood lipid, serum inflammatory cytokines and oxidative stress indexes before and after treatment were detected. Moreover, the serum VEGF level was examined, the central macular thickness (CMT), retinal neovascularization (RNV) leakage area and best corrected visual acuity (BCVA) of retinopathy were observed, and the vascular endothelial function indexes such as nitric oxide (NO), endothelin-1 (ET-1) and intercellular adhesion molecule-1 (ICAM-1) were detected. The therapeutic effect in the observation group was significantly better than that in control group (P<0.05). In observation group after treatment, the levels of GLU, total cholesterol (TC), triglyceride (TG), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), myeloperoxidase (MPO), malondialdehyde (MDA) and catalase (CAT) in the serum, VEGF, CMT and RNV, as well as NO, ET-1 and ICAM-1 were remarkably decreased (P<0.05), while those of superoxide dismutase (SOD) and BCVA were evidently increased (P<0.05). The changes were more significant at 3 months after treatment than those at 1 month. TA combined with AG can inhibit inflammation and oxidative stress, improve vascular endothelial function and retinal function and reduce VEGF expression in DR patients. The overall effect of the combined therapy is good, and its application is worth popularizing.

The effect of oleozone gel vs triamcinolone acetonide in ora base on the treatment of erosive/atrophic lichen planus in medically compromised patients

Background Oral lichen planus (OLP) is a common T–cell mediated chronic inflammatory disease, with unknown etiology. One of the etiological factors is involvement of some systemic diseases such as liver disease, diabetes mellitus, and hypertension. The immune system disturbances and oxidative stress may play a role in its pathogenesis. Corticosteroids are the mainstay for treatment of OLP and have its side effects. Oleozone gel was another suggested medication used to treat OLP. Aim The aim was to evaluate the beneficial effect of oleozone gel in the treatment of atrophic/erosive lichen planus in medically compromised patients and to compare it with the effect of triamcinolone acetonide in ora-base as a gold standard treatment. Materials and methods Twenty patients with symptomatic atrophic/erosive OLP were medically compromised and randomly assigned for treatment with 0.1% triamcinolone acetonide gel (group 1) or oleozone gel (group 2). The pain score (visual analog scale) and tumor necrosis factor-α were assessed at baseline (before treatment), 1 month and 3 months. Results Showed nonsignificant differences between the two treatment groups in reducing visual analog scale score and tumor necrosis factor-α value. Conclusion The study revealed that oleozone gel was found to be effective as triamcinolone acetonide in ora-base (0.1%) gel in the treatment of atrophic/erosive OLP in medically compromised patients.

EFFECT OF CRUDE EXTRACT AND PHYTOSTEROL FRACTION OF FUMARIA OFFICINALIS IN INDUCED HYPERTROPHIC SCAR OF RABBITS

Objective: The present study aimed to evaluate the role of crude extract and phytosterol fraction of Fumaria officinalis in experimentally induced hypertrophic scar in rabbits.&#x0D; Methods: Surgical wounds were performed on day 1 with an 8‑mm biopsy punch four wounds were created on the ventral surface of the rabbit ear (in vivo) down to cartilage. Triamcinolone acetonide (TAC), crude and phytosterol extracts of F. officinalis L. are administered topically to established scars on day 31. The outcome measures included study of histopathology of skin sections, transforming growth factor beta‑1 (TGF‑β1), level, and collagen three alpha1 in skin tissue.&#x0D; Results: In comparison with the induced hypertrophic scar, all treatment produced a significant reduction in scores of TGFβ1, collagen III, inflammation, and measurement of SEI (p ≤ 0.01). The most significant reduction in inflammation and thickness observed in TAC and extract of crude F. officinalis L. Only crude F. officinalis L. decrease fibroblast counts in comparison to induced hypertrophic scar group and other group (p ≤ 0.05). No statistically significant differences were found between the treatment groups in terms of TGF β1and collagen III.&#x0D; Conclusion: Topical crude extract of F. officinalis L. was more effective in the treatment of induced hypertrophic scar as compared with phytosterol of F. officinalis L. and comparable to the effectiveness of topical TAC.

Effect of intravitreal or sub-tenon triamcinolone acetonide injection at completion of vitrectomy on peripheral retinochoroidal thickness in eyes with proliferative diabetic retinopathy

The effect of triamcinolone acetonide (TA) on the peripheral retinochoroidal thickness was determined after pars plana vitrectomy (PPV) with scatter photocoagulation in eyes with proliferative diabetic retinopathy. The peripheral retinochoroidal thickness was measured at 5 mm from the limbus in the four quadrants using anterior segment optical coherence tomography before, and 3 days, and 1 and 2 weeks after the surgery. The total peripheral thickness was significantly thicker than the baseline thickness after PPV alone (P < 0.001; 18 eyes), PPV combined with intravitreal TA injection (IVTA; P = 0.011; 19 eyes), and PPV combined with sub-tenon TA injection (STTA; P = 0001; 23 eyes). The total peripheral thickness in the PPV group at 3 days after surgery was significantly thicker than that of the PPV + IVTA (P = 0.015) and of the PPV + STTA groups (P = 0.016). Multiple linear regression analyses showed that the injection of TA by the two routes and the number of photocoagulation burns were significantly correlated with the total peripheral thicknesses at 3 days after the surgery. The results indicate that the PPV with large number of intraoperative scatter photocoagulation burns caused an increase in the total peripheral thickness and an administration of either IVTA and STTA can reduced the degree of thickening.

Comparison of the effects of triamcinolone acetonide or platelet-rich plasma on expression of extracellular matrix-related genes in equine healthy chondrocytes in vitro

ABSTRACT: In healthy cartilage, chondrocytes maintain an expression of collagens and proteoglycans and are sensitive to growth factors and cytokines that either enhance or reduce type II collagen synthesis. In osteoarthritis, pro-inflammatory cytokines, such as IL-6, induce overexpression of metalloproteinases (MMP) and decreasing synthesis of aggrecan. Use of chondroprotectors agents, such as Platelet-Rich Plasma (PRP) and triamcinolone (TA) are alternatives to reduce the progression of joint damage. In this study, we used chondrocytes extracted from metacarpophalangeal joints of healthy horses as the experimental model. Cells were treated in vitro with PRP or TA. No differences were observed between these treatments in comparison to the control group when the expressions of MMP9, MMP13, IL-6 and ACAN genes were evaluated (P&lt;0.05). With these results, we can suggest that the treatments were not deleterious to equine cultured chondrocyte, once they did not stimulate MMPs and IL-6 synthesis or caused changes in ACAN.

Effects and safety of triamcinolone acetonide-controlled common therapy in keloid treatment: a Bayesian network meta-analysis.

BackgroundTriamcinolone acetonide (TAC) is used frequently in the treatment of keloid scars, but has presented controversial results. In this study, we aim to evaluate the effectiveness of TAC compared with other common therapies used in keloid treatment.MethodsMEDLINE, Embase, Web of Science and the Cochrane Library databases were searched until January 2018. Key data were extracted from eligible randomized controlled trials. Both pairwise and network meta-analyses were conducted for synthesizing data from eligible studies.ResultsTen randomized controlled trials were included in this meta-analysis. The relative risk of keloids associated with seven adjuvants was analyzed, including placebo, pulsed dye laser (PDL), 5-fluorouracil (5-FU), silicone, verapamil, TAC+5-FU and TAC+5-FU+PDL. Patients treated with the following adjuvants appeared to not have significantly reduced risk of keloid in relation to those treated with TAC: placebo (OR=1.86, 95% CI 1.12–2.61), PDL (OR=1.32, 95% CI 0.53–3.30), 5-FU (OR=1.13, 95% CI 0.48–2.68), silicone (OR=1.28, 95% CI 0.59–2.78), verapamil (OR=1.86, 95% CI 0.67–5.14), TAC+5-FU (OR=0.77, 95% CI 0.38–1.58) and TAC+5-FU+PDL (OR=0.80, 95% CI 0.16–4.03). The surface under the cumulative ranking curve values for each adjuvant were as follows: TAC, 59.9%; placebo, 17.4%; PDL, 46.3%; 5-FU, 48.9%; silicone, 56.2%; verapamil, 84.7%; TAC+5-FU, 68.5% and TAC+5-FU+PDL, 18.1%.ConclusionThere were no differences between the efficacy of TAC and other common therapies in keloid treatment. TAC also acts as an effective alternative modality in the prevention and treatment of keloids. Incorporating adjuvants particularly verapamil appeared to be significantly associated with a decreased risk of keloids.

Distribution, quantification and effects of triamcinolone acetonide in human osteoarthritic cartilage

Distribution, quantification and effects of triamcinolone acetonide in human osteoarthritic cartilage

The efficacy of intralesional triamcinolone acetonide (20mg/ml) in the treatment of keloid

Background: Management of keloid is difficult as well as challenging. Intralesional triamcinolone acetonide (TAC) injections have remained a gold standard in non-surgical management of keloid. TAC is generally used in the concentration of 40mg/ml, which causes adverse effects such as local dermal atrophy and hypopigmentation. Aim was to study efficacy and adverse effects of TAC in treatment of keloid, in a lesser concentration of 20mg/ml.Methods: An open label study was conducted from November 2015 to May 2017 on 25 subjects of either gender, in the age group 11-55 years, at a medical college hospital. Intralesional injection TAC 20 was administered in the keloid at an interval of 3 weeks, for a total of 6 sessions, over a period of 18 weeks. Vancouver scar scale (VSS) was used to assess the improvement and SPSS 21 for statistical analysis.Results: Mean age of keloid subjects was 30.72 years and median duration of keloid was 8 months. The mean VSS score before treatment was 8.36 which reduced to 3.20 after treatment. Mean percentage change in VSS score was 62.79%, which was very highly significant (p &lt;0.001). Physician’s assessment was ‘Very Good’ in 52.0% and ‘Excellent’ in 5 (20%). Adverse effect of atrophy was seen in 3 (12%), hypopigmentation in 11 (44%) and telangiectasia in 4 (16%).Conclusions: Intralesional injection triamcinolone acetonide 20mg/ml gives very good to excellent improvement in the majority of patients of keloid. Local adverse effects seen were hypopigmentation, atrophy and telengiectasia.

The Efficacy of Triamcinolone Acetonide in Keloid Treatment: A Systematic Review and Meta-analysis.

Keloid is a cutaneous dermal outgrowth resulting from uncontrolled deposition of collagen and glycosaminoglycan around the wound. The uncontrolled and persistent growth of keloids scar will result in cosmetic disfigurement, functional impairment, and affect the quality of life. Triamcinolone acetonide (TAC) is traditionally employed in treating keloid scars. In this study, we aim to evaluate the effectiveness of TAC and compare it with other common therapy employed in keloid treatment. Only randomized controlled trial (RCT) and controlled trial were included. Inverse variance risk ratio, weighted mean difference, and corresponding 95% confidence intervals were calculated to evaluate the effect of intervention. Meta-analysis indicated that TAC treatment significantly reduced the size of keloid compared to untreated control. Reduction in size was statistically different in favor of TAC compared to silicone gel sheet. Significant difference in favor of TAC was observed compared with verapamil in term of vascularity and scar pliability. TAC treatment was more effective in reducing scar thickness in comparison with cryotherapy. However, the current meta-analysis has several limitations. Only a limited number of trials with the same comparison are available. Most trials recruited a small number of patients and used inconsistent outcome assessment. Most trials did not provide detail information on allocation concealment and blinding. Therefore, further evaluation in multi-center RCTs with consistent comparisons and outcome measurements are warrant to reach a consensus on the selection between TAC and different treatment modalities.

The effect of triamcinolone acetonide or bevacizumab on the levels of proinflammatory cytokines after retinal laser photocoagulation in pigmented rabbits

Although laser photocoagulation is a gold standard for the treatment of retinal ischemic diseases, thermal burn induces the inflammation and the progression of macular edema. To prevent this complication, combination therapy using anti-vascular endothelial growth factor (VEGF) drugs or steroids is clinically utilized, however the mechanisms are still unclear. In this study, we aimed to evaluate the changes in inflammatory and angiogenic cytokine levels in aqueous humor and vitreous body after intravitreal injection of bevacizumab (IVB) or triamcinolone (IVTA), as well as sub-Tenon injection of triamcinolone (STTA) after retinal laser photocoagulation in rabbits. Pigmented rabbits were treated with retinal laser photocoagulation and divided into 4 groups, namely Control (no additional treatment), IVB, IVTA or STTA accordingly. Samples of vitreous and aqueous humor were collected on post-treatment days 0, 1, 7 and 14. The levels of intraocular VEGF, interleukin-6 (IL-6), intercellular adhesion molecule-1 (ICAM-1) and monocyte chemotactic protein-1 (MCP-1) were measured using an immunoassay. The levels of VEGF, IL-6, ICAM-1 and MCP-1 were significantly elevated 1 day after laser treatment. IVTA and STTA significantly reduced the increase in the levels of VEGF, IL-6, ICAM-1 and MCP-1, while IVB reduced that of VEGF only in aqueous humor and vitreous body. The protein amount in the aqueous humor transiently increased 1 day after laser, and was significantly prevented by IVTA or STTA but not IVB. Data showed that bevacizumab only reduced intraocular VEGF after laser, while triamcinolone suppressed both the expression of VEGF and proinflammatory cytokines. We propose that these cytokine profiles may play an important role in the pathogenesis of inflammation after photocoagulation and the underlying mechanism of treatment with anti-VEGF drug and steroids.

PROSPECTIVE STUDY OF INTRAVITREAL TRIAMCINOLONE ACETONIDE VERSUS BEVACIZUMAB FOR MACULAR EDEMA SECONDARY TO CENTRAL RETINAL VEIN OCCLUSION

To compare the efficacy and safety of intravitreal triamcinolone acetonide (IVT) versus intravitreal bevacizumab (IVB) for the treatment of macular edema (ME) secondary to central retinal vein occlusion. Prospective, consecutive, clinical interventional study. A total of 31 consecutive patients (32 eyes) with ME associated with central retinal vein occlusion were randomized to 2 groups. Sixteen eyes were treated with intravitreal injection of 4 mg/0.1 mL preservative-free triamcinolone acetonide; 16 eyes received IVB 1.25 mg/0.05 mL. Patients were given additional injections if they had ME as determined by optical coherence tomography 3 months after the first treatment or visual acuity loss of at least 2 lines in a Snellen chart. Best-corrected visual acuity, slit-lamp biomicroscopy, intraocular pressure, fundus fluorescein angiography, optical coherence tomography, the number of required injections, and adverse events were recorded during the 9-month follow-up period. Best-corrected visual acuity was significantly improved at 2 weeks and 1, 3, 6, and 9 months after injection in both the IVT and IVB groups, but no statistical difference was found between the 2 treatment groups during the 9-month follow-up period. The mean central macular thickness decreased at 1, 3, 6, and 9 months after injection within each treatment group, and no statistical difference was found between the 2 treatment groups at any time during the follow-up period (P > 0.05). Patients who received IVT treatment appeared to have quicker visual recovery and improved central macular thickness at Week 2 compared with those who received IVB treatment. Five of 16 eyes in the IVT group and 12 of 16 eyes in the IVB group required a repeated injection because of recurrent ME or unresolved intraretinal or subretinal fluid. The mean number of treatment was 1.31 ± 0.48 in the IVT group, as compared with 2.38 ± 1.04 in the IVB group. Significant intraocular pressure increase was found only in the IVT group, and six patients received topical intraocular pressure lowering medication, and one patient required trabeculectomy. Premacular membranes were developed in 2 patients in the IVT group. This is a prospective interventional study evaluating the efficacy and safety outcomes of IVT and IVB treatment for ME secondary to central retinal vein occlusion. Both IVT and IVB treatments can effectively improve best-corrected visual acuity and reduce central macular thickness in patients with ME secondary to central retinal vein occlusion without systemic side effects; no statistical differences were found in either best-corrected visual acuity or mean central macular thickness measurement between the two treatment groups. Both the effect of triamcinolone acetonide and that of bevacizumab were not permanent, and less injections were performed in the IVT group. However, triamcinolone acetonide causes more adverse events than bevacizumab.

The Effectiveness of Triamcinolone Acetonide vs. Procaine Hydrochloride Injection in the Management of Carpal Tunnel Syndrome

Corticosteroid injection into the carpal tunnel is frequently used for the treatment of carpal tunnel syndrome (CTS). Steroids are usually mixed with local anesthetics, which have positive effects that can aid the treatment of CTS by inhibiting the spontaneous discharge ability of excitable cells. The aim of this study was 3-fold: (1) to determine the efficacy of triamcinolone acetonide injection in the treatment of CTS, (2) to determine the efficacy of procaine hydrochloride (HCl) in the treatment of CTS, and (3) to compare the efficacy of triamcinolone acetonide and that of procaine HCl in the treatment of CTS. This prospective, randomized, double-blind clinical trial included 99 patients (120 median nerves) with clinical and electrophysiologic evidence of CTS. The 120 median nerves were randomly assigned to one of three groups: group 1 received 40 mg of triamcinolone acetonide, group 2 received 4 ml of 1% procaine HCl, and group 3 received both 40 mg of triamcinolone acetonide and 4 ml of 1% procaine HCl. Clinical and electrophysiologic evaluations were performed at the study onset and at 2 and 6 mos after treatment. At the study onset, there were no statistically significant differences between the groups with respect to distal motor latency, compound motor action potential, compound sensory action potential, sensory nerve conduction velocity, or visual analog scale score; however, distal motor latency, compound sensory action potential amplitude, sensory nerve conduction velocity, and visual analog scale scores improved significantly in each group 2 mos after treatment (P < 0.05), and these improvements persisted at 6 mos after treatment (P < 0.05). Significant differences were not observed between groups 1 and 2 or between groups 1 and 3 with respect to electrophysiologic findings at baseline or 2 or 6 mos after treatment (P > 0.05). Group 3 had better compound sensory action potential amplitude and sensory nerve conduction velocity scores than group 2 did at 6 mos (P < 0.05) and better visual analog scale scores than group 2 did at 2 and 6 mos (P < 0.05). Local procaine HCl injection and steroid injection effectively reduced the symptoms of CTS and equally improved electrophysiologic findings. As such, procaine HCl can be used in CTS patients in whom steroid use is contraindicated.

Protective effects of triamcinolone acetonide upon the upregulation and phosphorylation of GAP 43 in an animal model of retinopathy of prematurity

The aim of the current study was to investigate the effects of triamcinolone acetonide (TA) upon the expression and phosphorylation of growth-associated protein 43 (GAP 43) in the retinas of oxygen-induced retinopathy (OIR) rats. Oxygen-induced retinopathy was induced by exposing Sprague-Dawley rats to hyperoxia (80% oxygen) from postnatal (P) days 2-14 and then returning the rats to normoxic conditions. Triamcinolone acetonide or a conditioned saline (control) was injected intravitreally into the right or left eye, respectively, of OIR rats at P15. We then assessed the molecular and histological changes in the expression of GAP 43 and phospho-GAP 43 in OIR and control rat retinas, and also after treatment with TA by RT-PCR, Western blotting and immunohistochemistry. Growth-associated protein 43 mRNA levels were found to be increased by 1.6-fold (p=0.001, n=5) in the retinas of P18 OIR rats compared with the control rats. The protein levels of GAP 43 and phospho-GAP43 were found to be elevated in the retina of P18 OIR rats (2.40- and 2.39-fold greater than each control, p<0.001, n=5, respectively). Immunoreactivities of GAP 43 and phospho-GAP 43 were stronger in the inner plexiform layer in OIR rat retinas compared with the control. However, treatment with TA attenuated GAP 43 and phospho-GAP 43 upregulation in the OIR retinas. Our results indicate that GAP 43 and phospho-GAP 43 participate in retinal (potentially pathologic) changes following oxygen-induced damage. Triamcinolone acetonide protects the retinal damage in relatively hypoxic retinas of OIR rats. Therefore, TA treatment does not induce the expression and phosphorylation of GAP 43 in OIR rat retinas.

Treatment With Triamcinolone Acetonide Prevents Decreased Retinal Levels of Decorin in a Rat Model of Oxygen-Induced Retinopathy

Purpose: To investigate the effect of triamcinolone acetonide (TA) on retinal expression of decorin in a rat model of oxygen-induced retinopathy (OIR).Materials and Methods: OIR was stimulated by exposing Sprague-Dawley (SD) rats to hyperoxia (80 ± 1.3% O2) from postnatal day (P) 2 to P14 and then returning them to normoxia (room air, 21 ± 1.5% O2). Control rats were maintained in normoxia. At P15, TA (40 mg/ml) was injected into the right vitreous of OIR rats and saline into the left vitreous of control rats. All rats were sacrificed at P18. RT-PCR, western blot and immunohistochemistry, TUNEL assay were performed to detect the effects of TA on molecular and morphological changes in retinal decorin levels in P18 OIR rats.Results: In P18 OIR rats, mRNA and protein of retinal levels and immunoreactivity of retinal decorin were significantly less (p-value = 0.0000000012, 0.0007, 0.000003; n = 5; respectively) than in control rats. In addition, neuronal cell death was increased in P18 OIR rats (p-value = 0.0028; n = 5) relative to controls. However, treatment with TA prevented the decrease of mRNA, protein levels, and immunoreactivity in retinal decorin in P18 OIR rats (p-value = 0.00023, 0.003, 0.000079; n = 5, respectively), and restored neuronal cell death in P18 OIR rats (p-value = 0.0022, n = 5).Conclusion: Our results suggest that decorin is involved in hypoxic retinal damage and that TA protects retinal neurons damaged by relative hypoxia from decreased decorin levels.