Long-term outcomes of intraoperative triamcinolone injection versus postoperative oral prednisolone in congenital cataract surgery / Resultados de longo prazo do uso intraoperatório de triancinolona versus oral pós-operatório de prednisolona na cirurgia de catarata congênita

ABSTRACT Purpose: To compare the long-term ocular findings of children that were operated of congenital cataract before the age of two and that received an intraoperative intracameral triamcinolone injection or used postoperative oral prednisolone to modulate ocular inflammation. Methods: All patients who had previously participated in a clinical trial that analyzed the 1-year surgical outcomes of congenital cataract surgery utilizing intracameral triamcinolone (study group) or oral prednisolone (control group) were eligible to participate in this prospective cohort research. Patients' medical records were reviewed, and the children underwent a complete ophthalmologic exam on final follow-up. Biomicroscopic findings, intraocular pressure, central corneal thickness, the need for additional surgical interventions, and findings compatible with glaucoma were the primary end measures. Results: Twenty-six eyes (26 patients) were included (study group = 11 eyes; control group = 15 eyes). The mean follow--up was 8.2 ± 1.2 years and 8.1 ± 1.7 years in the study and control groups, respectively (p=0.82). All eyes presented a centered intraocular lens. There was no statistically significant difference between the groups with regards to the presence of posterior synechia (p=0.56), intraocular pressure (p=0.49), or central corneal thickness (p=0.21). None of the eyes fulfilled the glaucoma diagnostic criteria, presented secondary visual axis obscuration, or were reoperated. Conclusion: The long--term ocular findings of children that underwent congenital cataract surgery and received an intraoperative intracameral triamcinolone injection were similar to those that used postoperative oral prednisolone to modulate ocular inflammation. This suggests that intracameral triamcinolone may substitute oral prednisolone in congenital cataract surgery, facilitating the postoperative treatment regimen and compliance.

RESUMO Objetivo: Comparar os achados oculares em longo prazo de crianças que se submeteram à cirurgia de catarata congênita antes dos dois anos de idade e receberam uma injeção intracameral de triancinolona no intraoperatório ou usaram prednisolona oral no pós-operatório para modular a inflamação ocular. Métodos: Neste estudo prospectivo de coorte, todos os pacientes que participaram de um ensaio clínico anterior, que analisou os resultados cirúrgicos de 1 ano da cirurgia de catarata congênita usando triancinolona intracameral (Grupo de Estudo) ou prednisolona oral (Grupo Controle), eram elegíveis para participar. Os prontuários médicos dos pacientes foram revisados e as crianças foram submetidas a um exame oftalmológico completo no acompanhamento final. As principais medidas de desfecho foram: achados biomicroscópicos, pressão intraocular, espessura central da córnea, a necessidade de intervenções cirúrgicas adicionais e achados compatíveis com glaucoma. Resultados: Vinte e seis olhos (26 pacientes) foram incluídos (Grupo de Estudo = 11 olhos; Grupo de Controle = 15 olhos). O seguimento médio foi de 8,2 ± 1,2 anos e 8,1 ± 1,7 anos nos Grupos de Estudo e Controle, respectivamente (p=0,82). Todos os olhos apresentavam lente intraocular centrada. Não houve diferença estatisticamente significativa entre os grupos com relação à presença de sinéquia posterior (p=0,56), pressão intraocular (p=0,49) ou espessura central da córnea (p=0,21). Nenhum dos olhos preencheu os critérios diagnósticos para glaucoma, apresentou opacificação secundária do eixo visual ou foi reoperado. Conclusão: Os achados oculares em longo prazo de crianças que se submeteram à cirurgia de catarata congênita e receberam uma injeção intracameral de triancinolona no intraoperatório foram semelhantes aos que usaram prednisolona oral no pós-operatório para modular a inflamação ocular, sugerindo que a triancinolona intracameral pode substituir a prednisolona oral na cirurgia de catarata congênita, facilitando o tratamento pós-operatório e a adesão ao mesmo.

Extralesional triamcinolone acetonide injection in the treatment of small chalazion

Purpose: To evaluate the effect of extralesional triamcinolone acetonide (TA) injection in the treatment of small chalazion (diameter ? 5 mm). Methods: Prospective interventional clinal study that included patients diagnosed as chalazion of small size not responding to conservative management for at least 2 weeks. All patients were treated with extralesional TA injection (4 mg). Successful resolution of a chalazion was defined as a decrease in size to 1 mm or smaller. Results: Thirty?eight patients were included in the study. The resolution was achieved in 33 (87%) patients. Nineteen (50%) patients had complete resolution after the first injection, and 13 (34.2%) patients had complete resolution after the second injection. Chalazion near the lower punctum needed more times of injections than those elsewhere (P = 0.02). Conclusions: Extralesional TA injection is effective in the treatment of both primary and recurred small chalazia. It is a simple and cost?saving procedure and can be considered an alternative first?line treatment for small chalazion.

Transcutaneous injection of triamcinolone acetonide for persistent glottic granulation after laser microsurgery

Abstract Objective The aim of study was to demonstrate that transcutaneous intralesional injection of Triamcinolone Acetonide (TA) under fibrolaryngoscopy could be an option for persistent granulation after Transoral Laser Microsurgery (TLM) in glottic cancer patients. Methods We recruited 32 patients, who had conservative treatment but failed. 20 patients accepted TA injection monthly until the granulation disappeared or did not shrink further. 12 patients chose to closely monitor. Results For the 20 patients, 17 (85.0%) patients' granulations completely disappeared. 3 (15.0%) patients' granulations had reduced 80%. For the 12 patients, 3 (25.0%) patients' granulations disappeared but 9 (75%) patients' granulations did not have an obvious change. Recurrence was not observed. Conclusion Our experience showed that transcutaneous intralesional TA injection for persistent granulation after TLM through cricothyroid membrane is an efficient, security, harmless and low recurrence method. Especially suitable for huge granulation which blocks the glottis and recur after a second operation.

“Dye another day!” – dyes in ophthalmology

Background: Dyes are substances that are an integral part of ocular procedures and surgeries. In Clinical practice, dyes help in better visualization and aid in diagnoses of ocular surface disorders. In Surgical practice, dyes help in better resolution of the structures that are otherwise naked to the surgeon’s eyes. Purpose: To educate ophthalmologists about the importance and uses of dyes. Synopsis: Dyes have become an important part of an ophthalmologists' clinical as well as surgical practice. This video aims at educating the different characteristics, uses, advantages and disadvantages of each dye. Dyes help in identifying the obscure and highlighting the invisible. The indications and contraindications as well as the side effects of each dye are discussed which would help ophthalmologists in the correct usage of these wonder substances. This video will also help the new eye doctors understand and utilize these dyes judiciously which would aid in their learning process and provide better patient care. Highlights: This video highlights the uses, indications, contraindications and side effects of all the dyes used in ophthalmology

Posterior sub-Tenon triamcinolone injection in the treatment of postoperative cystoid macular edema secondary to pars plana vitrectomy

Purpose: To evaluate the efficacy and safety of posterior sub?Tenon triamcinolone (PSTA) in chronic postoperative cystoid macular edema (PCME) after pars plana vitrectomy (PPV). Methods: Consecutive 22 patients who developed chronic PCME after PPV and underwent PSTA treatment were included in this retrospective study. Best?corrected visual acuity (BCVA) and central macular thickness (CMT) were measured pre injection and post injection at one month, three months, six months, and at last visit. The patients were divided into three groups according to the injection response status: complete, partial, and resistant. Results: The mean follow?up period was 26.4 ± 16.2 months after PSTA. According to pre?injection values, there was a significant improvement in the values of BCVA and CMT at the first, third, and sixth months and at the last examination (P < 0.05). In the final examination, PCME recovered completely in 12 patients, partially in 8 patients, and resistance was observed in 2 patients. Conclusion: Posterior sub?Tenon triamcinolone seems to be effective in chronic PCME following PPV.

Comparison of topical steroids versus adjunctive intracameral triamcinolone versus posterior subtenon triamcinolone in pediatric cataract surgery

Purpose: Prolonged postoperative topical corticosteroids are commonly given after pediatric cataract surgery to control inflammation. This study was undertaken to compare the efficacy, safety, and compliance of postoperative topical steroids and adjunctive intracameral (I/C) triamcinolone acetonide (tricort) and posterior subtenon (PST) triamcinolone in modulating postoperative inflammation after surgery. Methods: Forty?eight eyes of children with pediatric cataract between the ages of 5 and 10 years were randomized into three equal groups (T, I, S) before surgery. Group T received postoperative topical 1% prednisolone tapered over 4 weeks; Group I received adjunctive intraoperative I/C 1.2 mg/0.03 ml tricort and topical 1% prednisolone for 2 weeks postoperatively, and Group S received a single 0.5 ml (40 mg/ ml) PST tricort without topical steroids. Signs of inflammation, intraocular pressure (IOP), and central corneal thickness were assessed at day 1, week 1, week 3, week 6, and week 12 postoperatively with optical coherence tomography (OCT) macula to rule out cystoid macular edema at the sixth and 12th weeks postoperatively. Results: Posterior synechiae were present in two eyes out of 16 in groups T and I, which resolved. Severe anterior chamber cells were present in four eyes out of 16 in group T, in two eyes in group I, and in one eye in group S, which resolved. All groups had comparable pre? and postoperative IOP. Conclusion: In pediatric cataracts, outcomes were better with PST tricort and the adjunctive I/C tricort compared to postoperative topical prednisolone, for modulating postoperative inflammation

Adverse effects associated with peribulbar injection of triamcinolone for the treatment of thyroid eye disease: a retrospective case series / Efeitos adversos de injeções peribulbares de triancinolona na doença ocular da tireoide: estudo retrospectivo de uma série de casos

ABSTRACT Purpose: Peribulbar injection of triamcinolone is an alternative treatment for thyroid eye disease; however the safety profile of this therapeutic option remains controversial. The aim of this study was to describe the occurrence of local and systemic adverse effects after peribulbar injection of triamcinolone in patients with thyroid eye disease. Methods: This was a retrospective case series. Medical records of patients with thyroid eye disease treated with peribulbar injections of triamcinolone at a single academic institution between 2007 and 2019 were analyzed. Local and systemic complications were documented. Results: A total of 123 patients were treated. Only 11 patients (8.9%) developed local complications. The most frequent complication was the presence of superficial eyelid ecchymosis (nine patients; 7.3%). Notably, systemic complications (hyperglycemic and suprarenal inhibition after stop treatment) occurred in two patients (1.6%). All complications were transient, and the patients did not have any long-term sequelae. Conclusions: Peribulbar injection of triamcinolone for the treatment of thyroid eye disease is linked to a very low rate of local or systemic complications. Prospective studies are warranted to delve into this topic.

RESUMO Objetivo: A injeção peribulbar de triancinolona é um tratamento alternativo para doenças oculares da tireoide; no entanto, a segurança desse procedimento continua controversa. O objetivo deste artigo é descrever os efeitos adversos locais e sistêmicos de injeções peribulbares de triancinolona em pacientes com doença ocular da tireoide. Métodos: Estudo retrospectivo de uma série de casos. Foram analisados os prontuários médicos dos pacientes com doença ocular da tireoide tratados com injeções de triancinolona peribulbar em uma única instituição acadêmica entre 2007 e 2019. Foram documentadas as complicações locais e sistêmicas. Resultados: Um total de 123 pacientes foram tratados. Apenas 11 (8,9%) pacientes apresentaram complicações locais, sendo a mais frequente a presença de equimoses palpebrais superficiais (7,3%), enquanto 2 (1,6%) pacientes apresentaram complicações sistêmicas (hiperglicemia e inibição da suprarrenal após a interrupção do tratamento). Todas estas complicações foram transitórias e nenhum paciente apresentou sequelas de longo prazo. Conclusões: As injeções peribulbares de triancinolona nas doenças oculares da tireoide têm uma taxa muito baixa de complicações, tanto locais quanto sistêmicas. São necessários estudos prospectivos para aprofundar este tópico.

Electrochemical sensor for doping corticosteroids in sports / Sensor eletroquímico para corticosteróides dopantes nos esportes / Sensor electroquímico para el dopaje de corticoesteroides en los deportes

ABSTRACT Introduction: Identifying and measuring the concentration of Triamcinolone (TA) in biological fluids is essential, especially for patients receiving intensive antibiotic medication. Objective: Make a sensor for electrochemical detection of Triamcinolone (TA) as an anabolic steroid in sports using copper oxide nanomaterials-reduced graphene oxide nanoparticles (CuNPs/rGO). Method: After preparing rGO nanoparticles on a glassy carbon electrode (GCE) using the modified Hummers technique, Cu NPs were deposited on rGO/GCE. The applicability of Cu NPs/rGO/GCE was investigated to determine the TA concentration in a real sample that had been prepared. Results: The deposited irregular Cu NPs evidenced a diameter of about 80 nm, in agreement with SEM morphological investigations. Amperometric studies revealed that the linear range, detection limits, and sensitivity of CuNPs/rGO/GCE as a TA sensor were 10 to 80 µM, 10nM, and 0.06584 µA/µM, respectively. Conclusion: The results revealed that the RSD and recovery values were valid, providing adequate quality and reliability for practical analysis of real samples using Cu NPS/rGO/GCE. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: É essencial identificar e medir a concentração de triamcinolona (TA) em fluidos biológicos, especialmente para pacientes que recebem medicação antibiótica intensiva. Objetivo: Confeccionar um sensor para detecção eletroquímica da triamcinolona como esteróides anabolizantes em esportes utilizando nanomateriais de óxido de cobre-nanopartículas de óxido de grafite reduzido (CuNPs/rGO). Métodos: Após a elaboração das nanopartículas rGO em eletrodo de carbono vítreo (GCE) utilizando a técnica Hummers modificada, os NPs Cu foram depositados no rGO/GCE. A fim de determinar a concentração de TA em uma amostra real que tinha sido preparada, foi investigada a aplicabilidade de Cu NPs/rGO/GCE. Resultados: Os Cu NPs irregulares depositados evidenciaram um diâmetro de cerca de 80 nm, de acordo com as investigações morfológicas do SEM. Estudos de amperometria revelaram que a faixa linear, limites de detecção e sensibilidade do CuNPs/rGO/GCE como sensor TA foram de 10 a 80 µM, 10nM e 0,06584 µA/µM, respectivamente. Conclusão: Os resultados revelaram que os valores de RSD e recuperação eram válidas, fornecendo qualidade e confiabilidade adequadas para análises práticas de amostras reais usando Cu NPs/rGO/GCE. Nível de evidência II; Estudos terapêuticos - investigação dos resultados de tratamento.

RESUMEN Introducción: Es esencial identificar y medir la concentración de triamcinolona (TA) en los fluidos biológicos, especialmente en los pacientes que reciben medicación antibiótica intensiva. Objetivo: Fabricar un sensor para la detección electroquímica de triamcinolona como esteroides anabólicos en el deporte utilizando nanomateriales de óxido de cobre-nanopartículas de óxido de grafeno reducido (CuNPs/rGO). Método: Tras la preparación de las nanopartículas de rGO sobre el electrodo de carbono vítreo (GCE) utilizando la técnica de Hummers modificada, se depositaron los NPs de Cu sobre el rGO/GCE. Para determinar la concentración de TA en una muestra real que había sido preparada, se investigó la aplicabilidad de los NPs de Cu/rGO/GCE. Resultados: Los NPs de Cu irregulares depositados presentaban un diámetro de unos 80 nm, de acuerdo con las investigaciones morfológicas del SEM. Los estudios amperométricos revelaron que el rango lineal, los límites de detección y la sensibilidad de Cu NPs/rGO/GCE como sensor de TA era de 10 a 80 µM, 10nM y 0,06584 µA/µM, respectivamente. Conclusión: Los resultados revelaron que los valores de RSD y recuperación eran válidos, proporcionando una calidad y fiabilidad adecuadas para el análisis práctico de muestras reales utilizando Cu NPs/rGO/GCE. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Triamcinolone Acetonide combined with Aflibercept in the treatment of wet age-related macular degeneration with poor response to Ranibizumab / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the efficacy and safety of intravitreal injection of aflibercept combined with posterior sub-fascial injection of triamcinolone acetonide in the treatment of wet age-related macular degeneration(ARMD)with poor response to anti-vascular endothelial growth factor drugs.METHODS: Retrospective cohort study. From June 2018 to May 2020, a total of 60 patients(60 eyes)with refractory ARMD who had poor response to the treatment of anti VEGF drug ranibizumab were randomly divided into the control group of aflibercept and the observation group of triamcinolone acetonide combined with aflibercept, with 30 patients(30 eyes)in each group. Once a month, the patients in the two groups received intravitreal injection of aflibercept alone or intravitreal injection of aflibercept combined with posterior sub-fascial injection of triamcinolone acetonide for three consecutive times. The changes of best corrected visual acuity(BCVA), central macular thickness(CMT)and intraocular pressure were reviewed before injection and 1, 3 and 6mo after the third injection.RESULTS: The BCVA and CMT of the two groups were significantly improved 1, 3 and 6mo after the injection of the drug(P&#x003C;0.05). The mean intraocular pressure in the combined group was higher at 1mo after treatment than before, but it still within the normal range. There was a significant difference in intraocular pressure between the two groups(17.50±4.60 vs. 18.30±3.73mmHg, P&#x003C;0.05).CONCLUSION: Triamcinolone acetonide injection under the posterior fascia of the eyeball combined with intravitreal injection of aflibercept in the treatment of wet ARMD can effectively reduce macular edema and improve vision, which is more safe and reliable.

450 nm semiconductor blue laser vaporization combined with triamcinolone acetonide injection in the treatment of bladder neck contracture: a case report / 现代泌尿外科杂志

【Objective】 To evaluate the efficacy and safety of 450 nm semiconductor blue laser combined with triamcinolone acetonide injection in the treatment of bladder neck contracture (BNC). 【Methods】 A 61-year-old male patient with BNC and urethral stricture was treated with 450 nm semiconductor blue laser vaporization combined with triamcinolone acetonide injection. The surgery was performed with a small-caliber laser resectoscope of F22. The follow-up results 3 months after surgery were reported. 【Results】 The operation was successful, the operation time was 30 minutes, and the patient was discharged the next day after operation. Follow-up 3 months after operation showed the maximum urinary flow rate (Qmax) was 22.1 mL/s, the International Prostate Symptom Score (IPSS) was 2, the Quality of Life Scale (QoL) was 0, and no recurrence was observed. 【Conclusion】 It is safe and feasible to use 450 nm semiconductor blue laser combined with triamcinolone acetonide injection to treat bladder neck contracture through a small-caliber laser resectoscope of F22, especially for patients with urethral stricture. The short-term efficacy is satisfactory.

Efficacy of local injection of triamcinolone acetonide combined with surgery in the treatment of mass-type granulomatous mastitis / 西安交通大学学报(医学版)

【Objective】 To analyze the efficacy and safety of intralesional triamcinolone acetonide in the treatment of mass granulomatous mastitis (GLM). 【Methods】 Retrospective analysis was made on 67 patients with GLM who were treated in Xijing Hospital from July 2021 to May 2022 and met the inclusion criteria. Among them, 31 patients were treated with local injection of triamcinolone acetonide, while 36 ones were treated with oral methylprednisolone. All the included patients underwent surgical treatment after their condition met the surgical criteria, and the follow-up period lasted for up to six months after surgery. The two groups were compared in improvement of symptoms and signs, treatment time, clinical effectiveness and safety, and recurrence rate. 【Results】 The effective rate of triamcinolone acetonide group and methylprednisolone group was 100%, but the clinical cure rate was significantly higher in triamcinolone acetonide group than in methylprednisolone group in stratified analysis (P<0.05). The improvement time of symptoms and signs in triamcinolone acetonide group was significantly shorter than that in methylprednisolone group (P<0.05). The incidence of side effects in triamcinolone acetonide group was also significantly reduced compared to methylprednisolone group (P<0.05). Follow-up for half a year showed no recurrence in both groups. 【Conclusion】 Compared with the traditional oral methylprednisolone group, local injection of triamcinolone acetonide in the treatment of mass granulomatous mastitis can rapidly relieve clinical symptoms and signs, shorten treatment time, and has higher efficiency and fewer side effects. Local injection of hormone combined with surgery is effective in treating mass granulomatous mastitis with low recurrence rate.

Effects of ethanol and propylene glycol alone or in combination on the transdermal properties of triamcinolone acetonide spray solution / 药学实践杂志

Objective To conduct in vitro transdermal test on triamcinolone acetonide spray solution, and investigate the effects of ethanol and propylene glycol alone or in combination on the in vitro transdermal function of triamcinolone acetonide spray solution. Methods Rabbit abdominal skin was selected, and the in vitro penetration test of triamcinolone acetonide spray solution was carried out by Franz diffusion cell method, and the content of triamcinolone acetonide was determined by HPLC. The rate of transdermal absorption was compared. Results The transdermal absorption rate of the combined use of ethanol and propylene glycol was significantly higher than that of the single use (P<0.05), and the order of promoting the penetration of triamcinolone acetonide spray solution when ethanol and propylene glycol were combined by 10% ethanol + 25% propylene glycol >10% ethanol + 20% propylene glycol >15% ethanol + 25% propylene glycol >15% ethanol + 20% propylene glycol. Conclusion The combination of 10% ethanol and 25% propylene glycol could optimize the transdermal function of triamcinolone acetonide spray solution.

Research progress on the combination therapy of diabetic macular edema / 中华眼底病杂志

Diabetic macular edema (DME) is the most threatening complication of diabetic retinopathy that affects visual function, which is characterized by intractability and recurrent attacks. Currently, the clinical routine treatments for DME mainly include intravitreal injection, grid laser photocoagulation in the macular area, subthreshold micropulse laser, periocular corticosteroid injection, and vitrectomy. Although conventional treatments are effective for some patients, persistent, refractory, and recurrent DME remains a clinical challenge that needs to be urgently addressed. In recent years, clinical studies have found that certain combination therapies are superior to monotherapy, which can not only restore the anatomical structure of the macular area and effectively reduce macular edema but also improve visual function to some extent while reducing the number of treatments and the overall cost. This makes up for the shortcomings of single treatment modalities and is highly anticipated in the clinical setting. However, the application of combination therapy in clinical practice is relatively short, and its safety and long-term effectiveness need further exploration. Currently, new drugs, new formulations, and new therapeutic targets are still under research and development to address different mechanisms of DME occurrence and development, such as anti-vascular endothelial growth factor agents designed to anchor repetitive sequence proteins with stronger inhibition of vascular leakage, multiple growth factor inhibitors, anti-inflammatory agents, and stem cell therapy. With the continuous improvement of the combination application of existing drugs and treatments and the development of new drugs and treatment technologies, personalized treatment for DME will become possible.

The efficacy of triamcinolone acetonide peribulbar injection combined with vitrectomy for rhegmatogenous retinal detachment associated with choroidal detachment / 中国医师杂志

Objective:To investigate the clinical efficacy of triamcinolone acetonide peribulbar injection combined with vitrectomy for rhegmatogenous retinal detachment associated with choroidal detachment (RRD-CD).Methods:This study was a retrospective case series study. Nineteen cases (19 eyes) with RRD-CD who had undergone pars plana vitrectomy at the Dalian No.3 People′s Hospital were analyzed. All the cases received 20 mg triamcinolone acetonide peribulbar injection within 3 to 7 days before surgery. The severity of patient′s uveitis was assessed before and after peribulbar injection of triamcinolone acetonide. Best corrected visual acuity (BCVA) and intra ocular pressure (IOP) before and after surgery, the area of retinal detachment, the rate of retinal reattachment, the rate of recurrent retinal detachment and surgical complications were analyzed. Patients′ blood pressure and blood glucose levels were also monitored.Results:19 patients were followed up for (13.1±1.5)months. The severity of uveitis reduced to different extents compared with preoperative condition. The IOP was (8.73±3.38)mmHg before injection and (10.95±2.46)mmHg after injection, and the difference was statistically significant ( t=-7.571, P=0.027). The choroid detachment range was 4-12(9.37±2.69)sites before injection, and 0-11(4.63±4.10)sites after injection, and the difference was statistically significant ( Z=-3.834, P=0.001). Compared with the preoperative results, the BCVA increased in 12 patients, unchanged in 5 cases and decreased in 2 cases. In the final follow-up of 18 patients with retinal reattachment, 17 eyes underwent a single operation, 2 eyes had recurrent retinal detachment, and 1 eye had retinal reattachment after a second operation. There were no significant difference in blood glucose and blood pressure before and after injection (all P>0.05). There were no other complications besides temporarily elevated IOP and cataract. Conclusions:Vitrectomy combined with triamcinolone acetonide peribulbar injection is effective and safe for patients with RRD-CD.

Safety and efficacy of suprachoroidal triamcinolone acetonide for the management of serous choroidal detachment prior to rhegmatogenous retinal detachment surgery: A Pilot study

Purpose: To study the safety and efficacy of pre?operative suprachoroidal triamcinolone acetonide (SCTA) for achieving reduction/resolution of serous choroidal detachment (CD) associated with rhegmatogenous retinal detachment (RRD). Methods: This was a prospective, noncomparative, interventional pilot study. All consecutive patients presenting with RD and coexisting CD underwent transconjunctival injection of SCTA before proceeding with vitrectomy/scleral buckle surgery. Sequential ultrasound B scans were performed for assessing the change in height of the CD. Results: The mean age of the cohort was 53.8 � 10.8 years (range: 39� years). The CD was present in a median of 3 quadrants; the cumulative mean CD height was 5.59 mm (range: 2.02�42 mm). Following SCTA, a successful response (>50% reduction) was seen in five eyes by day 3 and in two eyes by day 5. Three eyes failed to respond to SCTA and required surgical drainage before proceeding with vitrectomy. No intraprocedural injection?related complications were noted. A transient rise in the intraocular pressure (30 mmHg) was seen in one eye following vitrectomy and was managed successfully with topical antiglaucoma medications. Conclusion: Suprachoroidal administration of triamcinolone appears to be a safe and effective technique to achieve CD resolution in eyes with RRD.

Research progress on the adverse reactions of triamcinolone acetonide in oral lichen planus and its countermeasures / 中国医师杂志

Oral lichen planus (OLP) is a common chronic inflammatory oral mucosa disease, which is closely related to immune deficiency. Triamcinolone acetonide is considered to be the drug of choice for treatment of OLP due to its anti-inflammatory, anti-allergic and immunosuppressive effects. However, long-term application of triamcinolone acetonide can produce a variety of adverse reactions, and it prone to rebound after discontinuation, which greatly hinders the clinical diagnosis and treatment of OLP. This article reviews the adverse reactions of triamcinolone acetonide in the treatment of OLP and its coping strategies in order to provide some reference for the clinical treatment of OLP.

Evaluation of efficacy of combination therapy of intravitreal conbercept with posterior sub-Tenon triamcinolone acetonide for treatment of macular edema secondary to non-ischemic branch retinal vein occlusion / 中华实验眼科杂志

Objective:To evaluate the efficacy of combination therapy of intravitreal conbercept (IVC) with posterior sub-Tenon injection of triamcinolone acetonide (PSTA) in treating macular edema secondary to non-ischemic branch retinal vein occlusion (BRVO).Methods:A nonrandomized controlled study was conducted.Fifty-nine patients (59 eyes) diagnosed with macular edema secondary to non-ischemic BRVO were enrolled in Heping Hospital Affiliated to Changzhi Medical College from October 2016 to November 2019.The subjects were divided into IVC group (28 eyes) and combination therapy of IVC with PSTA group (IVC+ PSTA group for short) (31 eyes). IVC group received IVC 0.5 mg and IVC+ PSTA group received IVC 0.5 mg combined with PSTA 40 mg as the initial therapy, then a pro re nata (PRN) IVC administration was adopted for the two groups.The mean best corrected visual acuity (BCVA) converted to the logarithm of the minimum angle of resolution unit, central macular thickness (CMT) and intraocular pressure (IOP) before and 1, 3, 6 months after injection were measured and compared.The number of repeated IVC injections and relevant complications were recorded.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Heping Hospital Affiliated to Changzhi Medical College (No.20160R9). Written informed consent was obtained from each subject prior to any medical examination.Results:There was a statistically significant difference in BCVA between the two groups among different time points ( Fgroup=0.464, P=0.498; Ftime=25.454, P<0.001). Compared with before injection, the BCVA of both groups was significantly improved at each time point after injection (all at P<0.001). There was a statistically significant difference in CMT between the two groups among different time points ( Fgroup=6.208, P=0.016; Ftime=155.505, P<0.001). The CMT of both groups at each time point after injection was significantly smaller than that before injection, and the CMT in IVC+ PSTA group at 1 and 3 months after injection was smaller than that in IVC group (all at P<0.05). There was a statistically significant overall difference in IOP between the two groups ( Fgroup=9.994, P=0.006; Ftime=2.679, P=0.056). At 1 and 3 months after injection, the IOP in IVC+ PSTA group was higher than that in IVC group, showing statistically significant differences (both at P<0.01). There were 4 eyes with an IOP higher than 21 mmHg (1 mmHg=0.133 kPa) in IVC+ PSTA group.Within the 6-month follow-up, the mean number of repeated IVC injections of IVC group was 1.25±0.93, which was higher than 0.61±0.72 of IVC+ PSTA group, and the difference was statistically significant ( P=0.039). No other ocular complication was observed in both groups. Conclusions:Combination therapy of IVC with PSTA is effective in improving the BCVA and macular edema of patients with macular edema secondary to non-ischemic BRVO.A single PSTA injection can enhance the effect of conbercept in reliving macular edema in early months and reduce the number of repeated conbercept injections in the short term.

Treatment of myopic foveoschisis via triamcinolone assisted fovea-sparing internal limiting membrane peeling / 中国医师杂志

Objective:The aim of this study was to observe the clinical effects of myopic foveoschisis (MF) via triamcinolone (TA) assisted fovea-sparing internal limiting membrane peeling (FSILMP).Methods:This study was prospective research, including 41 cases (44 eyes) of patients diagnosed with MF in Changsha Aier Eye Hospital from November 2018 to June 2020. All patients underwent combined TA assisted FSILMP and 25 G pars plana vitrectomy (PPV). The posterior vitreous cortex, epiretinal membrane and internal limiting membrane (ILM) in the macular area were labeled by TA particles. The corrected visual acuity, central retinal thickness (CRT), post-operative healing of myopic foveoschisis and the incidence of macular hole were observed. Facilitating statistics, in this study, decimal visual acuity was converted to logMAR visual acuity through the formula logMAR=lg(1/decimal visual acuity).Results:Three cases underwent binocular surgery and 38 cases underwent monocular surgery. The average age of the patients was (56.16±11.00)years old ranging from 30-73 year olds; the average axial length of the patients was (30.50±1.96)mm which was ranging from 26.19-34.52 mm. The corrected visual acuity was 0.1-3(1.65±0.67) and the CRT was 126-1 100(473.47±195.96)mm. The patients were followed up for 1-31(13.89±8.32)months. A total of 38 cases (41 eyes) were followed up and 3 cases were lost. Reduction of MF in 41 eyes: 5 eyes (12.2%) were not healed, 12 eyes (29.3%) were improved, 8 eyes (19.5%) were near healed and 16 eyes (39.0%) were healed. The incidence of macular hole was 4.9% (2 eyes). The postoperative corrected visual acuity was 1.00±0.62, which was significantly higher than the preoperative corrected visual acuity [(1.65±0.67), t=8.23, P<0.01]. The postoperative CRT was (295.88±167.55)μm, which was significantly lower than that before operation (473.47±195.96)μm( t=7.82, P<0.01). Conclusions:TA can better mark the vitreous cortex, epiretinal membrane and inner limiting membrane of high myopia MF, and avoid the retinal toxicity caused by repeated indocyanine green (ICG) staining. At the same time, the effect of TA assisted FSILMP is no less than that of ICG assisted FSILMP in postoperative visual acuity recovery, CRT and the incidence of postoperative macular hole.

Clinical efficacy of intra-articular injection with Triamcinolone acetonide in patients with juvenile idiopathic arthritis / 中华实用儿科临床杂志

Objective:To observe the clinical efficacy of intra-articular injection with Triamcinolone acetonide on the treatment of juvenile idiopathic arthritis (JIA).Methods:The clinical data of 26 children diagnosed with JIA undergoing the intra-articular injection of Triamcinolone acetonide for the joints with obvious swelling and pain at the Children′s Hospital Affiliated to Capital Institute of Pediatrics from October 2018 to December 2019 who were retrospectively analyzed.Erythrocyte sedimentation rate (ESR) and C-reactive protein(CRP) were tested before and after the application of Triamcinolone acetonide.Detailed clinical manifestations were recorded.The nonparametric Kruskal- Wallis test was used to compare the differences in clinical evaluation indicators and changes in laboratory tests at diffe-rent treatment times. Results:Among the 26 children, 8 were boys and 18 were girls.After the intra-articular injection of Triamcinolone acetonide, 9 cases (34.62%) achieved complete remission, 15 cases(57.69%) achieved partial remission, and 2 cases (7.69%) were not responsive to the intra-articular injection.The overall therapeutic efficacy was 92.31%.Compared with pre-treatment period, from 4 weeks after treatment, assessment of disease activity by the physicians and parents of the children was significantly improved after 4-week treatment, and the number of active joints, ESR and CRP and the Juvenile Arthritis Disease Activity Score with 27 joints (JADAS 27) gradually decreased, and the differences were statistically significant (all P<0.05). No adverse drug reactions were seen during the treatment and follow-up period. Conclusions:Intra-articular injection of Triamcinolone acetonide is effective in contro-lling joint symptoms of JIA with less adverse events.

Aspirin inhibits the growth of hypertrophic scar in rabbit ears via regulating Wnt/β-catenin signal pathway / 中南大学学报(医学版)

OBJECTIVES@#Steroidal anti-inflammatory drugs have certain side effects in the treatment of hypertrophic scar, and the scar recurrence is easy after withdrawal of steroid anti-inflammatory drugs. Finding reliable alternative drugs is an effective means to improve this defect. Aspirin, a traditional non-steroidal anti-inflammatory drug, is safe for topical use and has anti-inflammatory effects similar to those of steroidal anti-inflammatory drugs, which may have similar effects on the treatment of hypertrophic scar. This study aims to investigate the inhibitory effect of aspirin on the proliferation of hypertrophic scar in rabbit ears and the underlying mechanism.@*METHODS@#The rabbit ear hypertrophic scar models were prepared. The rabbits were randomly divided into a normal skin group (group A), a blank control group (group B), a 0.9% NaCl group (group C), a 0.2% aspirin group (group D), a 0.5% aspirin group (group E), a 2% aspirin group (group F), and a triamcinolone acetonide group (group G). Macroscopic observation of hyperplasia was performed 8 weeks after local injection of the scar, followed by collecting the scar tissue samples for HE staining, Masson staining, and immunohistochemistry, respectively to assess the proliferation of fibroblasts and collagen fibers, and calculate the hypertrophic index, microvessel density, and immunohistochemical score.@*RESULTS@#All rabbit ear hypertrophic scar models were successfully constructed. In groups B and C, the hypertrophic scar edge was irregular, with reddish protruding epidermis, significant contracture and hard touch. In group D, E, and F, with the increase of aspirin administration concentration, the scar became thinner and gradually flat, the proliferation of fibrocytes and collagen fibers was weakened, and the hypertrophic index was gradually decreased (P<0.05). Immunohistochemistry showed that the expression of β-catenin was decreased in the group D, E and F in turn, and the immunohistochemical score was gradually decreased (P<0.05). There was no significant difference in hypertrophic index, microvessel density, and immunohistochemical score (all P>0.05).@*CONCLUSIONS@#Local injection of aspirin can reduce the generation of hypertrophic scar in a dose-dependent manner within a certain concentration range; aspirin inhibits the growth of hypertrophic scar in rabbit ears by inhibiting Wnt/β-catenin signal pathway; 2% aspirin and 40 mg/mL triamcinolone acetonide have similar curative efficacy on hypertrophic scar.