Triamcinolone Therapy Research Articles

TREATMENT OF SERPIGINOUS CHOROIDITIS WITH SUBTENON TRIAMCINOLONE IN CONJUNCTION WITH SYSTEMIC STEROIDS: A CASE REPORT.

To report two cases of serpiginous choroiditis which were treated with subtenon triamcinolone in conjunction with systemic steroids to control acute and chronic disease progression. Increased success of disease remission has been postulated for subtenon triamcinolone therapy in conjunction with systemic steroids. Retrospective chart review of two serpiginous choroiditis patients who presented at an eye center. Both patients received subtenon triamcinolone and systemic steroids. Visual acuity and disease course are reported. Both cases of serpiginous choroiditis received subtenon triamcinolone on presentation and were hospitalized for IV corticosteroids and systemic workup. The first patient had been on oral corticosteroids before presentation. Both patients reported same-day visual improvement after subtenon triamcinolone was administered. These two case reports describe unique clinical scenarios in which subtenon triamcinolone was used in both the acute and chronic phases of serpiginous choroiditis. Local steroid therapy can be a useful adjunctive therapy when systemic steroids are delayed, contraindicated, or intolerable.

Efficacy and Patient Satisfaction Associated With Intramuscular Triamcinolone Therapy for Acute Flares of Hidradenitis Suppurativa.

A lack of consensus exists regarding acute flare management in hidradenitis suppurativa (HS). Intramuscular triamcinolone (IMTAC) therapy is useful in numerous inflammatory conditions; however, it has not been investigated for acute HS flares. To evaluate the efficacy and patient experience associated with IMTAC therapy for acute, severe HS flares. Retrospective analysis and surveys of 45 HS patients were conducted at Albert Einstein College of Medicine/ Montefiore HS Center, Bronx, NY, USA. Follow-up visits 6.77 (4.45) weeks after IMTAC therapy revealed significant reductions in mean HS-Physician Global Assessment (PGA) (P < .001), C-Reactive Protein (CRP) (P = .03), increased hemoglobin (P = .004), and improved pain scores (P < .001). Adjusting for age, sex and concomitant medications, multivariate analysis yielded significantly reduced pain (P = .02) and increased hemoglobin (P = .03). Patient surveys indicate that IMTAC was well-tolerated, as reflected in positive mean responses for satisfaction (29 [64%]) and willingness to receive IMTAC injections again (42 [93%]). These novel findings demonstrate that IMTAC is a safe, effective, and well accepted adjunct for acute HS management.

Comparative efficacy of intralesional verapamil hydrochloride, triamcinolone acetonide and combination of both drug in hypertrophic scars and keloids at tertiary care center

Background: Keloids and hypertrophic scars are still a therapeutic problem. Despite numerous proposed therapies reported in the literature, the management of keloid and hypertrophic scars is still challenging as there is no universally accepted treatment regimen. Compare the efficacy intralesional verapamil hydrochloride and triamcinolone acetonide separately as well as combination of both drug in treatment of hypertrophic scars and keloids.Methods: A retrospective study was carried out at the general surgery department (plastic surgery unit) at the JNUIMSRC Jaipur, Rajasthan. Total of 150 patients (60 males and 90 females) between 18 to 60 years of age were enrolled fulfilling the inclusion criteria. They were randomly categorized in to three groups (group A, B and C), based on treatment they received viz. verapamil alone, triamcinolone alone and combination of both drugs respectively. Assessment of the scars were done prior to or on the day of the first injection and at 24 weeks after the end of injection scheme by Vancouver scar scale (VSS). The decreasing values reflected clinical improvement of the scar.Results: Better improvement observed in all four parameters: height, vascularity, pliability and pigmentation among patients receiving combination of both triamcinolone-verapamil drugs as compare to those patients receiving drugs separately either verapamil or triamcinolone alone. For parameters height, pliability and pigmentation, the improvement was found to be statistically significant (p&lt;0.05)Conclusions: Study highlights that the combined verapamil and triamcinolone therapy scheme causes remarkable scar improvement in keloid and hypertrophic scars in comparison to single drug scheme.

Intralesional bleomycin injection for localized verrucous venous malformations

Intralesional bleomycin injection for localized verrucous venous malformations

COMPARATIVE OF INTRAARTICULAR INJECTION BETWEEN DEXTROSE PROLOTHERAPY VERSUS TRIAMCINOLONE ACETONIDE IN KNEE OSTEOARTHRITIS

Knee osteoarthritis (OA) is one of the most common cartilage degenerative disorders that is a major problem because it causes chronic pain and disability. Therefore the method of treatment and prevention of old age is a big challenge. The results of Dextrose Prolotherapy compared to Triamcinolone therapy research are still varied. Objective: to compare the effectiveness of Dextrose Prolotherapy and Triamcinolone Acetonide (TA) in the treatment of moderate knee knee OA.True experimental single blind study, at the Neurology Polyclinic Dr. Saiful Anwar General Hospital Malang for 6 months (July-December 2019). Group I; Dextrose Prolotherapy (15%) intraarticularly injected 3 times every 4 weeks and group II; TA one- time intraarticular injection. The parameters studied were The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Score, Numeric Rating Scale (NRS), and Range of Motion (ROM), weeks 0, 4, 8, 12 and 24. Forty samples consisted of; the 20 samples of the Dextrose Prolotherapy group consisted of; male: female = 2 (10%): 18 (90%), age 62.4 + 7.28, BMI 25.6 + 3.69 kg / m2, pain duration 22.35 + 20.10 months, history of physiotherapy 40.27 + 20.79 times. Kellgren–Lawrence osteoarthritis severity grade II; 17 (85%), grade III 3 (15%). TA group; male: female = 5 (25%):15 (75%), age 62.5 + 9.02, BMI 28.4 + 5.01 kg/m2, pain duration 15.95 + 16.55 months, history of physiotherapy 34 + 24.87 times. Kellgren – Lawrence osteoarthritis severity grade II; 18 (90%), grade III; 2 (10%). Comparison of NRS at rest Dextrose Prolotherapy vs TA of week 4 (2.60 vs 1.25), week 8 (1.65 vs 1.40), week 12 (0.8 vs 2.05), week 24 (0.75 vs 3.35). Comparison of NRS during activity Dextrose Prolotherapy vs TA week 4 (4.45 vs 3.35), week 8 (3.25 vs 3.55), week 12 (2.55 vs 4.30), week 24 (2.55 vs 5.80). Comparison of ROM flexion Dextrose Prolotherapy vs TA week 4 (127.05° vs 123.60°), week 8 (130.85° vs 122.95°), week 12 (130.85° vs 122.95°), week 24 (131.05° vs 122.10°). Comparison of WOMAC score Dextrose Prolotherapy vs TA week 4 (30.05 vs 22.45), week 8 (22.90 vs 23.95), week 12 (19.30 vs 29.05), week 24 (18.95 vs 35.40). Intraarticular Injection Dextrose Prolotherapy is more effective for the long term based on pain scale NRS, WOMAC score and ROM. Whereas short-term TA is more effective than Dextrose Prolotherapy.

Role of intralesional bleomycin and intralesional triamcinolone therapy in residual haemangioma following propranolol

Role of intralesional bleomycin and intralesional triamcinolone therapy in residual haemangioma following propranolol

Intratympanic Triamcinolone and Dexamethasone in the Treatment of Ménière's Syndrome.

To describe the safety and potential efficacy of intratympanic administration of triamcinolone (40 mg/mL) in the treatment of unilateral Ménière's syndrome. Single-institution retrospective analysis. Tertiary referral neurotology clinic. Eighteen patients diagnosed with unilateral Ménière's syndrome with vertigo refractory to medical management. Intratympanic injection of triamcinolone or dexamethasone. Kaplan-Meier analysis was implemented to determine the rate of successful vertigo control. Responders were defined as patients who achieved sufficient vertigo control to decline ablative therapy. Nonresponders were defined as those who did not achieve satisfactory vertigo control and required ablative or surgical therapy. Pre- and posttreatment audiogram data was used to evaluate changes in hearing. Patient follow-up data was assessed for complications potentially resulting from intratympanic therapy. No patient experienced profound hearing loss or other serious adverse events as a result of intratympanic triamcinolone therapy. Tympanic membrane perforation occurred in three (18%) patients, all of whom had received three or more previous intratympanic injections. Satisfactory vertigo control with intratympanic triamcinolone therapy was achieved in 14 (78%) of 18 subjects. Our results suggest that intratympanic triamcinolone therapy on an as-needed basis is a safe and potentially effective procedure for vertigo control in patients with Ménière's syndrome. These findings warrant the implementation of prospective, controlled trials to investigate its safety and efficacy further.

Cheilitis granulomatosa: Case series

Granulomatous cheilitis is an idiopathic inflammatory disorder characterized by persistent, asymptomatic, diffuse swelling of one or both lips. It is also considered as an oligosymptomatic or monosymptomatic form of Melkersson–Rosenthal syndrome. We herewith report five cases of granulomatous cheilitis of which three cases were females and two were males. The mean age was 41 years. The average duration of symptoms was 2.5 years (2–3 years). Four patients presented with asymptomatic persistent swelling of the upper lip and one patient with lower lip. Two cases showed associated fissuring and angular cheilitis. One case also showed involvement of the left cheek. All the patients showed moderate improvement with combination of minocycline and intralesional triamcinolone therapy.

Clinical efficacy of low dose 5-fluorouracil with triamcinolone for treatment of keloids

Objective To evaluate the efficacy of low dose 5-fluorouracil (5-Fu) combined with triamcinolone in the treatment of keloids, comparing with results with use of triamcinolone treatment alone. Methods Patient records from 2012 to 2013 were reviewed. 45 patients (56 keloids) were completely randomized into 2 groups. Low dose of 5-Fu combined with triamcinolone were used to treat keloids in group A, while triamcinolone alone was used in group B. The therapeutic effects were evaluated by the certification of excellent remission, remission, inefficacy and total efficacy. The results were analyzed with statistics. Results In group A (27 keloids), the excellent remission cases were 16 (59.3%), the remission cases were 9 (33.3%), and the inefficacy cases were 2 (7.4%). The total percentage of efficacy in group A was 92.6%. In group B (29 keloids), the excellent remission cases were 9 (31.0%), the remission cases were 12 (41.4%), and the inefficacy cases were 8 (27.6%). The total therapy efficacy percentage of group B was 72.4%. Both the total percentage of efficacy and the excellent remission percentage in group A were apparently higher than those of group B, and the differences between the two groups were of statistical significance (P<0.05). The recurrence rates of group A were 3.7% (one case) while that of group B were 24.1% (7 cases). The differences between the two groups were also of statistical significance (P<0.05). Conclusions Low dose 5-Fu combined with triamcinolone is superior to intralesional triamcinolone therapy alone in the treatment of keloids. Key words: Keloid; 5-Fluorouracil; Triamcinolone

Efficacy and safety of postvitrectomy intravitreal triamcinolone therapy for diabetic macular edema.

After vitrectomy, diffusion and clearance rates of numerous drugs are increased, leading to a shorter intravitreal half-life. This raises doubts about the efficacy of intravitreal therapies, as retina specialists generally believe that a shorter half-life compromises the drugs' therapeutic effect. We conducted a study to evaluate the functional and anatomical effect of intravitreal triamcinolone acetonide therapy (IVTA) in previously vitrectomized eyes with diabetic macular edema (DME). In this retrospective, multicenter case series study including vitrectomized patients with DME who underwent IVTA injections, central macular thickness (CMT) measured with spectral-domain optical coherence tomography and best-corrected visual acuity (BCVA) in Early Treatment Diabetic Retinopathy Study letters were evaluated after each procedure. All relevant medical data were collected, including previous ophthalmologic treatments and comorbidities. Twenty vitrectomized eyes of 20 patients, mean age 58.1 years (range 40-72 years), were enrolled in the study. All patients presented DME and received at least one IVTA injection. Mean time between pars plana vitrectomy and IVTA was 12.9 ± 8.7 months. Mean pretreatment and posttreatment CMT was 438.8 ± 90.8 μm and 301.2 ± 76.2 μm, respectively, a difference that reached statistical significance (p&lt;0.001). Mean gain in BCVA letter score was 7.83 ± 14.9 letters after treatment (p = 0.039). Mean intraocular pressure was significantly increased after IVTA (17.2 ± 1.9 mm Hg at baseline vs 21.2 ± 4.59 mm Hg after IVTA, p = 0.002). A positive anatomical and functional effect was observed in our cohort. Our results suggest that, despite prior vitrectomy, triamcinolone remains a valid therapeutic approach for eyes with persistent DME. Further prospective randomized studies with larger patient samples are needed to validate this conclusion.

Foveal Serous Retinal Detachment in Juvenile Idiopathic Arthritis-associated Uveitis

Purpose: In juvenile idiopathic arthritis (JIA)-associated uveitis complicated by foveal serous retinal detachment (FSRD), we documented the relationship between best corrected visual acuity (BCVA), level of anterior chamber flare and OCT features.Methods: Nine children (15 eyes) with FSRD were identified among 38 children with JIA-associated maculopathy. Outcome measures included BCVA, ocular inflammatory activity quantified by laser flare photometry and the macular profile analyzed by OCT.Results: The diagnosis of FSRD led to intensification of the treatment using subtenon’s injection of triamcinolone or systemic immunomodulatory therapy. The improvement of BCVA at presentation (0.46 logMAR) was significant at 36 months follow-up (0.15 logMAR). The resolution of FSRD along with visual improvement (p = 0.0032) correlated with improvement in anterior chamber flare (p = 0.01).Conclusion: FSRD is a complication of chronic JIA-associated uveitis that responds well to intensification of immunomodulation. Visual improvement is correlated with FSRD resolution and with flare photometry values.

Postcricoid infantile hemangioma: Management of a case in the propranolol era

Postcricoid infantile hemangioma: Management of a case in the propranolol era

A cross sectional study of oral submucous fibrosis in central India and the effect of local triamcinolone therapy.

The use of processed arecanut is on the increase. In the impending danger of increased occurrence of oral submucous fibrosis and subsequent oral cancer following this habit is colossal. So an attempt is made to clinically evaluate the condition and to evaluate the effect of triamcinolone on this condition. Using the clinical data collected from the patients presenting in the ENT OPD of NSCB Medical College Hospital, Jabalpur, a cross sectional study was done and the effect of intralesional triamcinolone on this condition is noted by biweekly submucosal injections of 40mg triamcinolone for 12weeks and followed up for 1year. The effect of therapy was evaluated subjectively by improvement in symptoms and objectively by increase in mouth opening. The age of occurrence and sex predilection also showed a significant change with more young males being affected by the condition. There was no significant correlation between effect of triamcinolone therapy and duration of addiction but a significant correlation (P<0.0001) was noted with the frequency of addiction per day. A significant improvement in mouth opening is observed following local triamcinolone therapy. The results imply that the exposure and the frequency of chewing habits, and not mere the duration that is significant in producing the condition and affecting the treatment outcome. Local triamcinolone therapy has good effect in the initial stages of the disease. The fact that more youngsters are being affected needs serious consideration.

Color Doppler Imaging of Ocular Blood Flow after Combined Photodynamic Therapy with Intravitreal Triamcinolone in Age-Related Macular Degeneration

Purpose: To investigate the effect of combined intravitreal triamcinolone and ocular photodynamic therapy on retinal and choroidal hemodynamics in age-related macular degeneration.Methods: Intravitreal triamcinolone (4 mg, 0.1 cc) and photodynamic therapy with verteporfin were applied to 48 eyes of 33 subjects (25 male and 8 female; mean age: 68.9 years) with subfoveal choroidal neovascular membrane secondary to age-related macular degeneration. Patients were assessed for ocular hemodynamic parameters with color Doppler imaging 24 hr before and 1 week, 1 month, and 3 months after a single-dose administration of combined intravitreal triamcinolone and photodynamic therapy.Results: Throughout the study period, no significant difference in resistance index, peak systolic velocity, or end diastolic velocity existed in the ophthalmic artery (P = 0.58, P = 0.18, and P = 0.19, respectively), the posterior ciliary arteries (P = 0.73, P = 0.19, and P = 0.34, respectively), or the central retinal artery (P = 0.09, P = 0.32, and P = 0.47, respectively).Conclusion: Combined intravitreal triamcinolone and photodynamic therapy was not associated with any alteration in ocular blood flow or flow velocity over 3 months in eyes with age-related macular degeneration.

Subconjunctival triamcinolone treatment for non-necrotising anterior scleritis

AimsTo determine the outcome of treatment with subconjunctival triamcinolone acetate for non-necrotising anterior scleritis and to review the literature on this treatment.MethodsA retrospective, interventional case series of 12 patients who...

Acute Retinal Necrosis Complicating Chickenpox in a Healthy Adult—A Case Report and Review of Literature

Acute retinal necrosis (ARN) is known to occur in conjunction with primary varicella or chickenpox infection. The majority of ARN cases reported in the literature were of milder form with mild to moderate vitritis, limited retinitis, and rare occurrence of retinal breaks or detachment that responded well to intravenous acyclovir, with or without oral prednisolone. We report a case of unilateral ARN with marked vitritis and retinal necrosis leading to retinal breaks following chickenpox in a 32-year-old healthy lady. This patient was successfully treated with intravenous acyclovir followed by oral acyclovir and orbital floor triamcinolone injections to contain the inflammation with barrier laser therapy to secure the retinal breaks with good visual outcome. This case is unusual in its severity, and to our knowledge, orbital floor triamcinolone therapy was not used earlier to contain ARN inflammation.

Exhaled nitric oxide after a single dose of intramuscular triamcinolone in children with difficult to control asthma

In a previous study, we reported that intramuscular (IM) triamcinolone improves symptoms in children with difficult asthma. In 2005, we revised our difficult asthma protocol to include assessment of airway inflammation, both directly using sputum induction and indirectly by measurement of exhaled nitric oxide (eNO). In this retrospective review, we aimed to describe (i) the changes in eNO and symptoms after a single 60 mg dose of IM triamcinolone and (ii) the changes in inflammatory markers in the subgroup with non-eosinophilic asthma (i.e., an induced sputum eosinophil differential count <2.0%). Seven children received IM triamcinolone during the study period. In all children, symptom scores fell in the week following the IM injection (P < 0.01 vs. the pre-treatment week), and remained reduced for up to 6 weeks. eNO also fell within a week after IM therapy (P < 0.01), and remained reduced for up to 4 weeks. Non-eosinophilic asthma was definitively identified in three children, and in this group, eNO and symptoms fell after the IM injection. We conclude that IM triamcinolone therapy reduces both eNO and symptoms for up to 4 weeks in children with difficult asthma. Our data provide preliminary evidence that IM triamcinolone is an effective anti-inflammatory therapy in children with induced sputum non-eosinophilic asthma.

Acute retinal necrosis complicating chicken pox in a healthy adult

We report a case of unilateral acute retinal necrosis (ARN) with marked vitritis and retinal necrosis leading to retinal breaks following chicken pox successfully treated with intravenous acyclovir followed by oral acyclovir, orbital floor triamcinolone injections to contain the inflammation, and barrier laser therapy to secure the retinal breaks with good visual outcome. This case is unusual in its severity and the novel use orbital floor triamcinolone therapy to contain ARN inflammation.

Effects of Endogenous Cyclotronic Ionic Resonance (ICR) on Macular Diabetic Edema: Preliminary Results

The intent in this research was to verify the effects of the application of low frequency magnetic fields to cases of macular diabetic edema. We treated six patients afflicted by non-proliferating diabetic retinopathy with macular oedema. Quantitative clinical appraisals of the retinal thickness were obtained for the Optical Coherence Tomography (OCT I). None of the cases affected by non-cystoid macular oedema (non-CMO), or with a relevant ischemic component, evidenced by retinal fluorangiography, had further worsening in their clinical course during the treatment. Only one of the patients, who underwent a long treatment period with ICR demonstrated a significant reduction of the macular edema, with no need of other invasive therapeutic procedures (intravitreous injection of triamcinolone and/or laser therapy).

Efectos secundarios de la triamcinolona en pacientes jóvenes

Efectos secundarios de la triamcinolona en pacientes jóvenes