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PubMed1981

Some effects of triamcinolone pretreatment on intravenous glucose tolerance test in patients with different thyroid function.

In 42 patients (17 hypothyroid -Hypo, 14 euthyroid -Eu and 11 thyrotoxic -TX) the intravenous glucose tolerance test was performed before and after triamcinolone sensitization. The blood sugar (BS), immunoreactive insulin (IRI), growth hormone (GH), inorganic phosphorus (P), calcium (Ca), and total proteins (TP) were assessed and glucose disappearance rate was calculated from absolute values (KGt) and from increments (KGi) of glucose. Triamcinolone caused a rise of BS in Eu an Tx subgroups and a decrease of KGt and KGi in Hypo and decrease of KGt in Tx. No differences were found in patterns of IRI, GH, TP and Ca, respectively, but a significant rise of P after triamcinolone was found in Hypo and Eu subgroup. When comparing the subgroups according to thyroid function, only mild differences could be demonstrated in BS pattern both during IVGTT and TIVGTT, but significant differences of KGt and KGi were found between Eu and Hypo subgroups. No differences were observed in patterns of IRI, GH and Ca (except fasting values in Eu and Hypo subgroups during IVGTT, but significant differences were found in the pattern of P and particularly of TP. Except of differences of TP and P, changes during TIVGTT were not more pronounced than those during IVGTT. The comparison of effects of triamcinolone pretreatment on IVGTT and on OGTT (as were described previously) demonstrated similar effects of triamcinolone in Eu subgroups (significant changes of BS, IRI and P), but different action in Hypo- and Tx subgroups (where the significant changes of BS, IRI and P during OGTT and IVGTT were not parallel). These findings may suggest a possible role of some gastrointestinal and/or hepatic factors in action of triamcinolone in impaired thyroid function, but not in normal persons.

Adult↗
PubMed1997

Prospective use of intramuscular triamcinolone acetonide in pseudogout.

OBJECTIVE: To prospectively assess the efficacy of intramuscular (i.m.) triamcinolone acetonide in the treatment of pseudogout. METHODS: Fourteen patients with crystal proven pseudogout presenting with an acute attack within 5 days of onset were treated with intramuscular triamcinolone acetonide 60 mg and followed for 30 days. Patients with inadequate response were eligible for a 2nd triamcinolone acetonide injection on Day 1-2. RESULTS: Twelve patients had contraindication to nonsteroidal antiinflammatory agents (NSAID). Acute arthritis was monoarticular in 10 patients, and involved 2 or more joints in 4 patients. All patients had good clinical response to triamcinolone acetonide based on restoration of near baseline joint range of motion and joint circumference, and at least 50% improvement in patient and physician global assessment. Major clinical improvement occurred by Day 1-2 (2 patients), Day 3-4 (11 patients), and Day 10-14 (one patient). Six patients required a 2nd triamcinolone acetonide injection on Day 1-2. Toxicities were not observed. CONCLUSION: I.m. triamcinolone acetonide appears to be safe, well tolerated, and effective in the treatment of pseudogout. It may be a reasonable alternative therapy when NSAID are contraindicated, and for polyarticular attacks where intraarticular corticosteroids are impractical.

Aged↗
PubMed1976

Subacromial triamcinolone mexacetonide and methylprednisolone injections in treatment of supra spinam tendinitis. A comparative trial.

This statistical report describes a clinical trial on 60 patients with supraspinal tendinitis for the comparison of triamcinolone hexacetonide (in a 20 mg/cc suspension in 1 cc ampoules) with methylprednisolone acetate (in a 40 mg/cc suspension in 1 cc ampoules). The objective of the study was to determine the therapeutic activity, including onset and duration of relief, of triamcinolone hexacetonide as a subacromial injection, and to compare these results with those obtained with similar injections of methylprednisolone acetate. The following results were obtained. Triamcinolone hexacetonide reduced pain, local tenderness and functional impairment to a greater degree than did methylprednisolone acetate. A significantly smaller proportion of patients needed a second injection of triamcinolone hexacetonide (33%) than needed a second injection of methylprednisolone acetate (63%). Triamcinolone hexacetonide appears to have longer duration of activity than does methyl-prednisolone acetate, judging by the percentage of patients still getting relief from their first injection at the end of the study period. The drugs were similar as regards side effect incidence rates and time to onset of action.

Adolescent↗
PubMedDate not supplied

Correction of the soft tissue pollybeak using triamcinolone injection.

OBJECTIVE: To describe the technique for correction of the soft tissue pollybeak deformity using intralesional injection of triamcinolone acetonide. METHODS: We discuss our philosophy, regimen, and technique for treatment of the soft tissue pollybeak using triamcinolone injection. We include results from a series of 173 patients who underwent rhinoplasty performed by one of us (N.J.P.). RESULTS: Triamcinolone was injected at 1 week after surgery in 127 patients (73%). A second injection was performed in 92 (72%) of the 127 patients at 4 weeks after surgery. One hundred eight (85%) of the 127 patients had an acceptable result, as judged by the surgeon, with good supratip definition. Nineteen (15%) of the 127 patients had a less than optimal result, with residual supratip fullness, as judged by the surgeon. There were no complications caused by triamcinolone injection. CONCLUSIONS: Because revision surgery is difficult and may be associated with complications, intralesional triamcinolone injection is the first-line treatment for the soft tissue pollybeak deformities caused by subdermal scarring. Should intralesional steroid injection fail to satisfactorily treat the deformity, revision rhinoplasty can subsequently be performed.

Adolescent↗
PubMed2003

Noninfectious endophthalmitis associated with intravitreal triamcinolone injection.

BACKGROUND: Intravitreal injection of triamcinolone has been advocated to treat exudative macular diseases such as macular edema and choroidal neovascularization. OBJECTIVE: To describe 7 patients who developed a clinical picture simulating endophthalmitis after intravitreal triamcinolone injection. METHODS: Intravitreal triamcinolone injections were performed to treat refractory cystoid macular edema or diffuse macular edema associated with diabetic retinopathy, macular pucker, branch retinal vein occlusion, or pseudophakia. One patient received an injection in an attempt to treat exudation associated with occult choroidal neovascularization. RESULTS: Preinjection visual acuity ranged from 20/50 to 20/400. An extensive inflammatory response developed 1 to 2 days after injection in all 7 eyes. Five eyes had previously undergone vitrectomy. Four eyes had a layered hypopyon. All 7 eyes had an anterior chamber cellular reaction and vitritis. Visual acuity ranged from 20/400 to hand movements. The first 6 patients were treated for presumed endophthalmitis with vitreous cultures and intravitreal injections of antibiotics. All 6 cultures were negative for any organisms, and the eyes resolved their inflammatory response, with recovery to preinjection visual acuity or better. The seventh patient was treated with topical prednisolone without antibiotic therapy, and the inflammation resolved, with resolution of the macular edema seen before the intravitreal triamcinolone injection. CONCLUSION: It may be appropriate to closely observe noninfectious, toxic endophthalmitis in patients treated with intravitreal triamcinolone before assuming it to be infectious, especially in the absence of eye pain.

Adult↗
PubMed2005

Predictive factors for visual acuity after intravitreal triamcinolone treatment for diabetic macular edema.

OBJECTIVE: To evaluate which factors influence maximum gain in best-corrected visual acuity after intravitreal injection of triamcinolone acetonide as treatment for diffuse diabetic macular edema. METHODS: This prospective clinical interventional study included 53 eyes with diffuse diabetic macular edema receiving an intravitreal injection of about 20 mg of triamcinolone. The mean +/- SD follow-up was 10.2 +/- 7.6 months. RESULTS: In a multiple linear regression analysis, maximum gain in best-corrected visual acuity after the intravitreal injection of triamcinolone was significantly (P < .001) and negatively correlated with an increased degree of macular ischemia and a higher preoperative visual acuity. Improvement in best-corrected visual acuity was significantly and positively correlated with increased degree of macular edema (P = .001). Change in best-corrected visual acuity after the intravitreal triamcinolone injection was statistically independent (P > .15) of age, sex, pseudophakia, and macula grid laser treatment before inclusion into the study. The results were comparable for gain in visual acuity at 6 months after the injection. CONCLUSION: Pronounced macular edema may have a positive impact, and marked macular ischemia and a high preoperative best-corrected visual acuity may have a negative impact, on an increase in best-corrected visual acuity after intravitreal triamcinolone injection in patients with diabetic macular edema.

Adult↗
PubMed1993

Potentiation of triamcinolone-induced cleft palate in mice by maternal high dietary fat.

This study investigated whether the current range in dietary fat levels, which has arisen partly in response to some major health concerns, would affect frequency of congenital anomalies if continued into the period of early pregnancy. The effect of 5.6%, or 48% of calories from fat in the maternal diet, was tested on pregnant strain CD-1 mice injected with triamcinolone in doses of 0.01 mg, 0.02 mg, 0.04 mg, or 0.06 mg per day on days 11 through 14 of gestation. Frequency of cleft palate increased with increasing doses of triamcinolone, with clefts of the palate being rare at the two lower doses. No clefts appeared without triamcinolone on either diet. In combination with triamcinolone treatment, 226 fetuses exposed to a maternal low fat diet had normal palates and 86 had cleft palates. With exposure to high fat, 186 fetuses had normal palates and 101 had cleft palates, which was a significant increase in clefting (p < 0.05). Also, the latter group showed a greater degree of retardation in palate development (p < 0.05). Thus both a greater frequency and a more severe form of clefting support the conclusion that high dietary fat potentiated the cleft palate-producing effects of triamcinolone in mice.

Animals↗
PubMed1985

Pharmacokinetics of triamcinolone acetonide and its phosphate ester.

Triamcinolone acetonide in the form of its phosphate ester was given intravenously in two different doses (10 mg/kg and 80 mg). Plasma levels of the ester and triamcinolone acetonide were measured and pharmacokinetic parameters were calculated. The pharmacokinetics both of the phosphate and the free alcohol were dose-dependent. No unchanged ester was found in the urine, indicating complete conversion of the pro-drug. Triamcinolone was not a major metabolite of triamcinolone acetonide in humans. Renal clearance was low and independent of the dose. Only about 1% of the dose was found in the urine as triamcinolone acetonide.

Adult↗
PubMed2006

Carboxymethylcellulose as a new carrier substance for intravitreal injection of reproducible amounts of triamcinolone.

BACKGROUND: Intravitreal application of triamcinolone acetonide has become increasingly popular for the treatment of various retinal disorders. However, dosage, mode of preparation and application differ worldwide. The aim of this study was to find a safe vehicle that would allow intravitreal injection of an exact amount of triamcinolone acetonide without potentially retinotoxic preservatives. METHODS: Solutions of triamcinolone acetonide with a theoretical concentration of 4 mg/0.2 ml were prepared following one sedimentation (A) and two filtration (B, C) methods. In addition, a filtration method using carboxymethylcellulose 2% as a carrier (D) was established. During processing and after injection into an eye model, the crystals were quantified by weight and high-performance liquid chromatography (HPLC), and, hence, the rate of crystal loss during this process was determined. RESULTS: The initial preparation contained 93-106% of the calculated quantity. Method A, containing the entire vehicle, delivered 45%+/-7.3% of the target quantity to the eye model, whereas the vehicle-free methods B and C delivered 15%+/-6.9% and 11%+/-3.2%, respectively. Using carboxymethylcellulose 2% as a preservative-free vehicle, we found 93%+/-3.7% of the calculated amount in the eye model. The missing crystals were mainly sticking to the walls of the syringes and needles used for transfer. CONCLUSION: Common methods for preparing triamcinolone acetonide vary in the amount of drug actually injected intravitreally. Carboxymethylcellulose is an ideal carrier substance for intravitreal application of an exact dose of triamcinolone acetonide without preservatives.

Carboxymethylcellulose Sodium↗
PubMed2006

Influence of different purification techniques on triamcinolone yield and particle size spectrum.

BACKGROUND: To systematically investigate the common purification techniques for commercially available triamcinolone acetonide preparations and the influence of different filter parameters on final yield, reproducibility and particle size spectrum. METHODS: Two non-filter techniques using either sedimentation or centrifugation, and two different filter techniques were tested. Filters with different characteristics were investigated with the pore size ranging from 0.1 to 5.0 microm, and the filter diameter ranging from 4 to 30 mm. Only sterile standard syringe filters with low adsorptive characteristics (hydrophilic cellulose filter membranes) for pharmaceutical use were employed. For quantification, triamcinolone acetonide was dissolved in 60% methanol and measured spectrophotometrically at 239 nm. The crystal size spectrum was determined using a particle size analyzer that combines electronic pulse area analysis and resistance measurement. RESULTS: Depending on the purification technique used the resulting triamcinolone doses differed significantly. While the centrifugation method achieved purification without relevant loss, the sedimentation method yielded only 28.7% compared to the original commercial suspension, and in addition, the predictability was low (range 8.1-17.2 mg). With filter techniques high and consistent doses with a good reproducibility were achieved, but results were highly dependent on the filter characteristics. The final triamcinolone amount inversely correlated with the filter diameter due to a uniform loss of crystalline particles. In contrast, enlarging the pore size caused a substantial shift in the particle size spectrum due to a selective loss of small crystalline particles. CONCLUSIONS: The most common purification techniques vary notably in regard to final triamcinolone doses, reproducibility and particle size spectrum. The appropriate choice of the filter parameters seems to be more important than assumed, as pore size and filter diameter substantially influence both the final TA doses and the particle size of the TA crystals.

Centrifugation↗
PubMed1999

Enzyme activity of rat tibialis anterior muscle differs between treatment with triamcinolone and prednisolone and nutritional deprivation.

The maximal activity of a selection of enzymes involved in muscle carbohydrate handling, citric acid cycle and fatty acyl beta-oxidation were studied after treatment with the fluorinated corticosteroid triamcinolone and compared to a similar treatment of the non-fluorinated corticosteroid prednisolone in an equipotent anti-inflammatory dose. Furthermore, because triamcinolone causes loss of body mass and muscle wasting, the effects of triamcinolone were investigated relative to a control group, with the same loss of body mass, due to nutritional deprivation. The study was performed in male Wistar rats in the following treatment groups: TR, triamcinolone treatment (0.25 mg x kg(-1) x day(-1) for 2 weeks), which resulted in a reduction of body mass (24%); ND, nutritional deprivation (30% of normal daily food intake for 2 weeks) resulting in a similar (24%) decrease of body mass as TR; PR, prednisolone treatment (0.31 mg x kg(-1) x day(-1) for 2 weeks), with a 10% increase in body mass; FF, free-fed control group, with a 12% increase in body mass in 2 weeks. Compared to FF, TR induced an increase in phosphofructokinase (PFK) activity (P < 0.01), glycogen synthase [GS(i + d)] activity (P < 0.05) and glycogen content (P < 0.01) in the tibialis anterior muscle. The PR and ND caused no alterations in PFK or citrate synthase (CS) activity compared to FF. Compared to PR, TR induced an increase in PFK (P < 0.01), CS (P < 0.05) and GS(i + d) activity (P < 0.01). Both TR and PR caused an increased muscle glycogen content, being more pronounced in TR (P < 0.05). Compared to ND, TR induced an increased CS (P < 0.05) and GS(i + d) activity (P < 0.01) and glycogen content (P < 0.01). The ND resulted in a decreased glycogen content compared to FF (P < 0.05). None of the treatments affected the activity of glycogen phosphorylase, beta-hydroxyacyl coenzyme A dehydrogenase and lactate dehydrogenase. It was concluded that corticosteroids led to an increased muscle glycogen content; however, the changes in the enzymes of carbohydrate metabolism were corticosteroid type specific and did not relate to undernutrition, which accompanied the triamcinolone treatment.

Animals↗
PubMed1992

The effect of budesonide and triamcinolone acetonide on hepatic microsomal testosterone metabolism in the rat.

The hepatic microsomal metabolism of testosterone was studied in male rats after treatment with either budesonide or triamcinolone acetonide for 13 weeks. The in vitro metabolism was determined using a testosterone concentration of 35 nM which is comparable to the levels found in plasma. It was shown that the total microsomal testosterone metabolism was decreased in budesonide-treated rats and increased in rats treated with triamcinolone acetonide. The testosterone metabolites produced were measured and thus it was revealed that budesonide treatment brought about its effect through a 50% decrease in the activity of steroid 5 alpha-reductase, but did not affect other reductive enzymes, or the oxidation of testosterone. Triamcinolone acetonide treatment decreased steroid 5 alpha-reductase activity by 95% and also decreased the activities of steroid 3 alpha- and 3 beta-reductases by more than 90%. In addition, treatment with triamcinolone acetonide caused a 50% increase in the oxidative metabolism of testosterone, which resulted in the observed increase in total testosterone metabolism. The presence of 0.1 microM budesonide in the microsomal incubations was without effect on testosterone metabolism. However, 0.1 microM triamcinolone acetonide inhibited testosterone oxidation by 65%, without affecting the reductive pathway of testosterone metabolism.

Animals↗
PubMed2004

Intraocular availability of triamcinolone acetonide after intravitreal injection.

BACKGROUND: To evaluate the intraocular concentration of triamcinolone acetonide after intravitreal injection. METHODS: The prospective clinical interventional case series study included 17 patients who had received a 20 to 25-mg intravitreal injection of triamcinolone acetonide as treatment for exudative age-related macular degeneration, diffuse diabetic macular edema, or retinal vein occlusions. During a secondary intraocular surgery taking place 4.1 weeks to 25.7 months after the intravitreal injection, aqueous humor samples were obtained. None of the eyes were vitrectomized. RESULTS: In the aqueous humor samples, triamcinolone acetonide was in low, but measurable, concentrations detected up to 1.5 years after the intravitreal injection. Concentrations found in samples obtained during the first 6 months, or 7 to 12 months, respectively, after the injection ranged between 3.0 microg/l and 436 microg/l, and between 0.0 microg/l and 11.2 microg/l, respectively. CONCLUSIONS: After injection of triamcinolone acetonide, triamcinolone can be present in measurable concentrations up to 1.5 years after the application.

Aqueous Humor↗
PubMed2004

Vitrectomy as a treatment for elevated intraocular pressure following intravitreal injection of triamcinolone acetonide.

PURPOSE: To report control of intravitreal triamcinolone acetonide-induced elevated intraocular pressure (IOP) by vitrectomy-assisted corticosteroid removal. DESIGN: Interventional case series. METHODS: Of the 26 eyes that had intravitreal injection of triamcinolone acetonide for various causes, 11 eyes (42.5%) developed elevated IOP. In nine eyes IOP was controlled by antiglaucoma medication. Two eyes of two patients developed uncontrolled IOP despite maximal antiglaucoma medication. These eyes underwent vitrectomy and removal of triamcinolone acetonide. RESULTS: IOP returned to normal in 3 weeks and 1 week, respectively, after vitrectomy. CONCLUSIONS: Elevated IOP associated with intravitreal injection of triamcinolone acetonide that is not controlled by maximal antiglaucoma medication can be effectively treated by vitrectomy-assisted removal of triamcinolone acetonide.

Drainage↗
PubMed2006

Photodynamic therapy with verteporfin and intravitreal triamcinolone acetonide in the treatment of neovascular age-related macular degeneration.

PURPOSE: To examine the efficacy of photodynamic therapy (PDT) with verteporfin and intravitreal triamcinolone acetonide in the treatment of neovascular age-related macular degeneration (AMD). DESIGN: Retrospective, interventional case series. METHODS: Sixty eyes of 56 patients with neovascular AMD were treated with PDT with verteporfin followed by an intravitreal injection of 4 mg triamcinolone acetonide. The main outcome measures were visual acuity (VA), retreatment frequency with PDT (and triamcinolone), and frequency of side effects. RESULTS: Mean follow-up was 15.9 months (range 12 to 30 months, median 15 months). Twenty-three (38.3%) of 60 eyes had a stable result at 12 months' follow-up (that is, loss/gain <three lines) and 34 (56.7%) of 60 had a loss of 3 lines or more. Three patients (5%) had an improvement of 3 lines or more. Lesion type, patient age, and lesion size had no influence on the outcome, but baseline VA had a statistically significant effect (P = .006). The median number of PDT-intravitreal triamcinolone acetonide treatments was one. One-third (20 of 60) of all eyes had an increase in intraocular pressure (IOP) that required therapy. There were no cases of endophthalmitis, but 13 patients (21.6%) developed severe cataract that required surgery. CONCLUSIONS: The combination of PDT and intravitreal triamcinolone acetonide requires careful consideration as a treatment option for neovascular AMD. In our case series, this treatment combination did not prevent a considerable decrease in VA. The main benefit of this combination treatment was a low number of verteporfin treatments. Baseline VA was the main predictor of the final outcome.

Aged↗
PubMed2006

Single perioperative triamcinolone injection versus standard postoperative steroid drops after uneventful phacoemulsification surgery: Randomized controlled trial.

PURPOSE: To evaluate the safety and efficacy of a single perioperative sub-Tenon's injection of triamcinolone following cataract surgery and its effect on the incidence of early pseudophakic cystoid macular edema (CME). SETTING: Ophthalmology Department, Queen's Medical Centre University Hospital, Nottingham. United Kingdom. METHODS: This prospective randomized controlled trial included 54 eyes (54 patients) having routine cataract surgery. Twenty-seven eyes received the conventional postoperative care with steroid drops (drops group), whereas the other 27 were given a perioperative sub-Tenon's injection of triamcinolone (injection group); 10 of these received 20 mg, and the remaining 17 eyes had 30 mg triamcinolone. All patients were evaluated preoperatively and at days 1, 8, 30, and 90. The outcome measures evaluated were logMAR best corrected visual acuity (BCVA), anterior chamber flare (Kowa-500 flare meter), intraocular pressure, and slitlamp biomicroscopy. Oral fluorescein angiograms were performed at 30 and 90 days to detect angiographic CME. RESULTS: The mean logMAR BCVA improved from a baseline of 0.38 +/- 0.38 (SD) and 0.44 +/- 0.26 to 0.02 +/- 0.14 and 0.0 +/- 0.07 at 90 days in the steroid drops and injection groups, respectively. (P = .59). The mean flare increased from a baseline of 8.9 +/- 3.2 photons/ms and 8.3 +/- 3.7 photons/ms in the steroid drops and injection groups, respectively, to a maximum of +/-14.1 photons/ms and 25.8 +/- 7.5 photons/ms at day 8. Mean flare decreased to 15.8 +/- 9.7 photons/ms and 13.8 +/- 10.1 photons/ms at 30 days (P = .48, difference between groups) and 10.4 +/- 3.6 photons/ms and 9.8 +/- 3.1 photons/ms at 90 days, respectively, in the 2 groups. Subanalysis revealed lowest peak flare (17.9 +/- 7.9 photons/ms) at 8 days in the group that received 30 mg triamcinolone. CONCLUSIONS: A single sub-Tenon's injection of 30 mg triamcinolone seem to be safe and effective as a route of steroid delivery after uneventful phacoemulsification surgery. Larger numbers in patients at high risk are required to assess its effectiveness in reducing the risk for pseudophakic CME.

Administration, Topical↗
PubMed2003

Biological activity and characteristics of triamcinolone-acetonide formulated with the self-regulating drug carriers, Transfersomes.

Novel formulations of the halogenated corticosteroid, triamcinolone-acetonide, based on ultradeformable mixed lipid vesicles, Transfersomes, are described. Their performance was tested in vivo using radioactive label measurements, to study the drug biodistribution, and murine ear edema, to determine the drug bioactivity. Sparse use of drug-loaded Transfersomes on the skin ensures an almost exclusive delivery of triamcinolone-acetonide into the organ, thus arguably increasing the treatment safety. Delivery of triamcinolone-acetonide in the skin with ultradeformable vesicles prolongs the anti-inflammatory drug action several times compared to drug usage in a conventional crème or an ointment, the robustness of biological response for the former being at least identical to the latter. The required dose of Transfersome-based triamcinolone-acetonide is also greatly reduced. The drug dose of 0.2 microg cm(-2) suppresses 75% of arachidonic acid-induced murine ear edema for at least 48 h. In contrast, a conventional formulation of triamcinolone-acetonide requires a 10-fold higher drug dosage to achieve a similar effect. In either case, increasing the applied corticosteroid amount delays the onset of anti-edema action.

Administration, Topical↗
PubMed2005

Complications of intravitreal injection of triamcinolone acetonide.

BACKGROUND: Intravitreal injection of triamcinolone acetonide appears to be a promising treatment for a variety of proliferative, edematous, neovascular and inflammatory ocular disorders. Reported complications include intraocular pressure (IOP) elevation, cataract formation, retinal detachment, vitreous hemorrhage and endophthalmitis. The purpose of this investigation was to report the complications of intravitreal triamcinolone injection that may be attributable to the injection procedure or to the corticosteroid suspension. METHODS: A total of 212 eyes of 180 patients who underwent intravitreal triamcinolone acetonide injection for various indications were enrolled. All patients received 8 mg/0.2 mL of triamcinolone. A total of 270 injections were performed by the same surgeon under topical anesthesia. The patients were followed for a mean of 9.2 months. Complications related to the injection procedure and to the corticosteroid were recorded. RESULTS: The most common complication encountered during follow-up was transient elevation of the IOP above 21 mm Hg (44 eyes [20.8%]). The average IOP rose by 28.5%, 38.2%, 16.7% and 4.2% from baseline at 1, 3, 6 and 9 months respectively. The mean IOP values at 1, 3 and 6 months were statistically significantly higher than the mean preinjection value (p < 0.001). Fourteen eyes (6.6%) had cataract progression and underwent cataract surgery with intraocular lens implantation. Endophthalmitis developed in one eye (0.5%); the patient underwent vitrectomy with silicone oil injection. Pseudoendophthalmitis occurred in one eye (0.5%), and pseudohypopyon was observed in two eyes (0.9%). INTERPRETATION: Intravitreal triamcinolone injection was effective in a variety of ocular disorders. Patients should be monitored closely given the potential for complications of the injection procedure or the corticosteroid suspension.

Cataract↗