- Triamcinolone acetonide-chitosan coated liposomes efficiently treated retinal edema as eye drops. [Journal Article]Exp Eye Res 2019; :107805EE
- Macular edema (ME), which is present in various retinal diseases, leads to permanent retinal structural damage and threatens vision. The intravitreal/periocular injection of triamcinolone acetonide (TA) can improve the prognosis of ME; however, further exploration of noninvasive delivery systems is essential. Therefore, as a continuation of our previous study using TA-chitosan coated liposomes (T…
Macular edema (ME), which is present in various retinal diseases, leads to permanent retinal structural damage and threatens vision. The intravitreal/periocular injection of triamcinolone acetonide (TA) can improve the prognosis of ME; however, further exploration of noninvasive delivery systems is essential. Therefore, as a continuation of our previous study using TA-chitosan coated liposomes (TA-CHLs) as a topical drug delivery system, the present study aimed to determine the drug safety, stability, permeability, and bioavailability of TA-CHLs. The study was based on detecting the delivery of a fluorescent dye to the retina using optical coherence tomography angiography in rats. Marked cellular uptake was observed in cell lines. TA-CHL toxicity was investigated in cell culture. Clinical ocular safety was evaluated by measuring the corneal thickness and intraocular pressure. In preclinical studies on a laser-induced retinal edema rat model, the TA-CHL eye drops had dramatic therapeutic effect in remission of retinal edema over 10 days. These results demonstrated that TA-CHL was nontoxic and had good bioavailability in vitro and in vivo. The results of the present study indicated that this formulation could be an effective therapeutic approach and the TA-CHL eye drops may represent a new option for retinal diseases.
- Eosinophilic otitis media and comorbid asthma. [Journal Article]Curr Opin Allergy Clin Immunol 2019CO
- CONCLUSIONS: EOM and asthma are closely related. Optimal asthma treatment is important for treating EOM. Treatments commensurate with the severity of EOM are being developed.
- Sustained Control from Recurring Non-Infectious Uveitic Macular Edema with 0.19 mg Fluocinolone Acetonide Intravitreal Implant - A Case Report. [Journal Article]Ophthalmol Ther 2019OT
- In January 2013, a 54-year-old pseudophakic woman was referred to the ocular inflammation clinic with a diagnosis of panuveitis, already on oral cyclosporine (100 mg/day) since 2010. She was a monocular patient, with the left eye eviscerated due to trauma and secondary endophthalmitis in 1995. She had experienced similar recurring episodes between 2010 and 2013. Examination revealed best-correcte…
In January 2013, a 54-year-old pseudophakic woman was referred to the ocular inflammation clinic with a diagnosis of panuveitis, already on oral cyclosporine (100 mg/day) since 2010. She was a monocular patient, with the left eye eviscerated due to trauma and secondary endophthalmitis in 1995. She had experienced similar recurring episodes between 2010 and 2013. Examination revealed best-corrected visual acuity (BCVA) of 20/200. The anterior segment revealed the presence of flare and absence of cells. Intraocular pressure (IOP) was 11 mmHg. Fundus examination revealed the presence of anterior vitreous organization, exuberant cystoid macular edema (CME) and peripheral Dalen-Fuchs nodules with no activity. Systemic workup showed no changes, and a presumptive diagnosis of sympathetic ophthalmia was made. Initial therapy included topical and systemic corticosteroids. Cyclosporine was replaced with methotrexate (20 mg/week) due to nephrotoxicity. There was marked improvement in anterior inflammation and vitreous organization, but the ME remained exuberant (central ring thickness of 0.7 mm). Over the subsequent 4 years of follow-up, the patient received two intravitreous injections of a dexamethasone extended-release implant (Ozurdex®), with normalization of macular thickness and improvement in visual acuity (VA), but ME recurred around 6 months post-injection. During this period, the patient also underwent three sub-tenon injections of triamcinolone, with marked improvement of ME, but ME recurred between 4 and 6 months after treatment. She was thus recommended for treatment with a fluocinolone extended-release implant (ILUVIEN®). Post-implantation (3-year follow-up), she had controlled anterior inflammation without ME (central macular thickness of 248 µm). This case suggests that sustained control of inflammation enables better control of ME, and benefits may persist even after cessation of the direct anti-inflammatory effect of the implant. FUNDING: Alimera Sciences Ltd funded the Rapid Service Fees.
- Novel Triamcinolone Acetonide-Loaded Liposomal Topical Formulation Improves Contrast Sensitivity Outcome After Femtosecond Laser-Assisted Cataract Surgery. [Journal Article]J Ocul Pharmacol Ther 2019JO
- CONCLUSIONS: TA-LF is associated with better CS outcomes compared to combined therapy after FLACS.
- Comparison of the Effect of Photodynamic Therapy and Topical Corticosteroid on Oral Lichen Planus Lesions. [Journal Article]Oral Dis 2019OD
- CONCLUSIONS: Photodynamic therapy can be used as an alternative therapy alongside standard methods or as a new modality for refractory OLP. This article is protected by copyright. All rights reserved.
- Intralesional triamcinolone acetonide therapy for inflammatory oral ulcers. [Journal Article]Oral Surg Oral Med Oral Pathol Oral Radiol 2019OS
- CONCLUSIONS: IST may be an effective treatment for inflammatory and immune-mediated oral ulcers.
- [Itchy rash caused by the oak processionary caterpillar]. [Journal Article]Ned Tijdschr Geneeskd 2019; 163NT
- CONCLUSIONS: The oak processionary caterpillar can cause a lot of symptoms in the period from April to July, including skin rash and eye and upper airway symptoms. The symptoms are usually self-limiting and automatically disappear within 2 weeks. In case of severe itching, menthol-based creams, topical corticosteroids and antihistamines may be prescribed.
- Acute, Sustained, Intraocular Pressure increases following Anti-Vascular Endothelial Growth Factor Treatment for Retinal Conditions: A Review of Clinical Evidence and Guidelines [BOOK]Canadian Agency for Drugs and Technologies in Health: Ottawa (ON)BOOK
- Vascular endothelial growth factor (VEGF) is a protein that is upregulated as a result of capillary dropout, hypoxia, and local inflammation secondary to increased intraluminal venous pressure from retinal vein compression and other forms of vascular occlusion such as branch retinal vein occlusion (BRVO) and choroidal retinal vein occlusion (CRVO).1 VEGF is linked to the development of retinal di…
Vascular endothelial growth factor (VEGF) is a protein that is upregulated as a result of capillary dropout, hypoxia, and local inflammation secondary to increased intraluminal venous pressure from retinal vein compression and other forms of vascular occlusion such as branch retinal vein occlusion (BRVO) and choroidal retinal vein occlusion (CRVO).1 VEGF is linked to the development of retinal diseases like age-related macular degeneration (AMD) and macular edema which are leading causes of vision loss.2,3 AMD and macular edema have been the target of several therapeutic developments including non-pharmaceutical options such as, macular grid laser photocoagulation augmentation (MGLA), laser-induced chorioretinal anastomosis, and surgery (e.g., pars plana vitrectomy).1 Pharmaceutical options are primarily corticosteroids and anti-VEGF agents. Steroids such as, triamcinolone and dexamethasone (DEX) function by decreasing inflammation and edema through the modulation of vascular permeability and inflammatory agents like VEGF.1 Common anti-VEGF agents are aflibercept, bevacizumab, pegaptanib sodium, and ranibizumab. Aflibercept (115 kDa) is a soluble recombinant decoy receptor fusion protein, bevacizumab (149 kDa) is a recombinant full-length humanized monoclonal immunoglobulin G1 antibody, pegaptanib sodium is a selective antagonist, while ranibizumab (48 kDa) is a recombinant humanized immunoglobulin G1 kappa isotype antibody fragment.1,3 In the Health Canada drug product database, aflibercept and ranibizumab are listed as antineovascularization agents, bevacizumab is listed as an antineoplastic, and pegaptanib sodium is listed as an anti-VEGF agent for AMD.4 Anti-VEGF agents are linked to a number of adverse effects such as, sustained elevated intraocular pressure (IOP), endophthalmitis, cataract progression, vitreous hemorrhage, retinal tears and detachments, pain, vitreous floaters, and inflammation.2,3 Patients may also experience non-ocular effects like hypertension, nasopharyngitis, and headache.2 Sustained elevated IOP may self-resolve or may need to be controlled by additional anti-VEGF agents, IOP-lowering topical or oral medication (e.g., carbonic anhydrase inhibitor), or surgery (e.g., trabeculectomy, laser trabeculoplasty, laser peripheral iridotomy, or filtration surgery).3 The aim of this report is to summarize the evidence regarding risk factors that lead to acute, sustained IOP increases that require surgery following anti-VEGF intravitreal injection treatment for retinal disease, and to review the relevant evidence-based guidelines.
- The Efficacy of Posterior Subtenon Triamcinolone Acetonide Injection in Treatment of Irvine-Gass Syndrome. [Journal Article]Ocul Immunol Inflamm 2019; :1-7OI
- CONCLUSIONS: PST injection is an effective and safe treatment for Irvine-Gass syndrome.
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- Local therapy for cancer therapy-associated uveitis: a case series and review of the literature. [Journal Article]Br J Ophthalmol 2019BJ
- CONCLUSIONS: Based on our series as well as the existing literature demonstrating the use of local therapy for irAEs, we propose an approach to local therapy for cancer therapy-associated uveitis starting with topical steroids and initiating injectable steroids in cases of recalcitrant panuveitis or posterior uveitis. Subclinical inflammation on posterior segment imaging responds robustly to difluprednate or intravitreal steroid therapy, and patients with posterior segment involvement may require more aggressive management and long-term maintenance.