sub-Tenon Capsule Injection Of Triamcinolone Acetonide Research Articles

Efficacy of posterior sub-tenon's capsule injection compared to intravitreal injection of triamcinolone acetonide for treatment of diabetic macular edema: A systematic review and meta-analysis

Background: Diabetic macular edema (DME) is defined as a retinal thickening in one-disc diameter of the center of the macula. It is a number of microvascular retinal changes that lead to blood-retinal barrier disruption, causing leakage of fluid and plasma components into the inner and outer plexiform layers. Aim of the Work: To conduct a systematic review and a meta-analysis estimating the efficacy and complications of posterior sub-Tenon's capsule injection of triamcinolone acetonide (STTA) compared to intravitreal injection of triamcinolone acetonide (IVTA) for management of DME. Materials and Methods: A comprehensive literature search was conducted using the databases Google Scholar, PubMed, MEDS, web of science, EMBASE, and Cochrane Library for published studies from January 01, 2000 to September 01, 2019. This meta-analysis included ten studies. They were randomized controlled clinical trials, and about 343 patients with DME (469 eyes) participated in these studies. Results: This study demonstrated a statistically significant change in the mean of best-corrected visual acuity (BCVA) improvement and central macular thickness (CMT) reduction in both groups when comparing the baseline to 1- and 3-month follow-ups after the injection, though with no statistically significant difference in the IVTA compared to the STTA group. At a 6-month follow-up, both groups showed no significant differences in the BCVA and CMT compared to the baseline. Both groups showed no statistical differences in the BCVA or CMT over the follow-up periods. Regarding intraocular pressure (IOP) changes, the present study showed that the mean IOP was elevated in both groups at 1- and 3-month follow-ups after the injection compared to their baseline. There was a statistically significant difference between both groups at 1 and 3-months. The IOP was more elevated in the IVTA compared to the STTA group. At a 6-month follow-up, both groups showed no significant difference in the IOP elevation compared to the baseline. IOP elevation was the most reported adverse effect in all included studies. Cataract formation is also reported in some studies, though no other complications, such as endophthalmitis, vitreous hemorrhage, and/or retinal detachment, are reported in any of the studies. Conclusion: STTA injection has a comparable effect to the IVTA injection and carries a lower risk of intraocular complications. It is considered an easy, safe, and valid alternative to intravitreal injection for the treatment of DME.

The effect of posterior sub-Tenon capsule injection of triamcinolone acetonide to inflammatory cytokines in rat retina after pan-retinal photocoagulation

Objective To observe the expression of inflammatory cytokines in diabetic rats received posterior sub-Tenon capsule injection of triamcinolone acetonide (TA) and pan-retinal photocoagulation.Methods A total of 48 Brown Norway rats received intraperitoneal injection of streptozotocin to establish the diabetic model.Diabetic rats were randomly divided into experimental group (20 rats),control group (20 rats) and blank group (8 rats).50 μl TA or saline was injected into the posterior sub-Tenon capsule immediately after the photocoagulation in the experimental group and the control group,respectively.The blank group received no treatment.The mRNA and protein expression level of retinal vascular endothelial growth factor (VEGF),interleukin 6 (IL-6) and tumor necrosis fator-α (TNF-α) were measured by quantitative polymerase chain reaction and enzyme-linked immunosorbent assay (ELISA) at 1,3,7 days after laser photocoagulation.Results The mRNA and protein expression of VEGF,IL-6,TNF-α of the experimental group and control group were significantly higher than the blank group,the difference was statistically significant (P＜0.05).The mRNA and protein expression of VEGF,IL-6 and TNF-α of the experimental group were significantly lower than that of the control group.On day 1 after laser photocoagulation,the mRNA expression of VEGF was not statistically significant in the experimental group and control group (P＞0.05),the mRNA and protein expression of VEGF,IL-6,TNF-α of the two groups were statistically significant in the remaining observing time (P＜0.05).Conclusion Posterior sub-Tenon capsule injection of TA can effectively reduce retinal photocoagulation induced VEGF,IL-6,TNF-α expression. Key words: Diabetic retinopathy/complications; Macular edema/drug therapy; Laser coagulation; Triamcinolone acetonide/therapeutic use; Chemokines

Indocyanine green angiography-guided laser photocoagulation combined with sub-Tenon's capsule injection of triamcinolone acetonide for idiopathic macular telangiectasia

AimsType 2 (perifoveal) telangiectasia often is refractory to treatment, because focal targets such as aneurysms are not detected by fluorescein angiography (FA) in these eyes. The authors evaluated the efficacy...