Kenalog
Frozen shoulder syndrome: comparison of oral route corticosteroid and intra-articular corticosteroid injection.

Widiastuti-Samekto M, Sianturi GP.

Department of Anatomy and Neurology, Faculty of Medicine Diponegoro University/Dr. Kariadi General Hospital, Semarang, Indonesia.

Twenty-six patients with frozen shoulder syndrome (Stage 2 and 3) were included in this study conducted at Dr. Kariadi General Hospital, Semarang, Indonesia and randomly allocated into 2 groups: 40 mg triamcinolone intra-articular injection and triamcinolone oral tablets. The result showed that triamcinolone intra-articular injection group "cured" rate was 5.8 times higher at week one compared to the triamcinolone tablet group. Sixty-two percent of the cases with triamcinolone intra-articular injection achieved their "cured" condition after one week of therapy, compared with only 14% of the triamcinolone tablets group. We conclude that, intra-articular corticosteroid injection provide faster improvement compared to oral route.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15727375&dopt=Abstract triamcinolone Kenalog



Kenalog
Posterior subtenon triamcinolone acetonide for refractory diabetic macular edema.

Bakri SJ, Kaiser PK.

Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio.

PURPOSE: To evaluate posterior subtenon injection of triamcinolone acetonide for refractory diabetic macular edema (DME). DESIGN: Retrospective, interventional, case series. METHODS: setting: Clinical practice. patient population: Patients with persistent clinically significant DME involving the center of the fovea 3 or more months after one or more treatments of focal macular photocoagulation were included. Exclusion criteria were a history of corticosteroid-responsive intraocular pressure (IOP) rise, intraocular surgery within 3 months, and any laser treatment within 1 month. procedure: All patients received an ophthalmic history and examination including best-corrected Snellen visual acuity, IOP measurement, anterior segment examination including evaluation of lens status with LOCS II criteria, dilated fundus examination, and a posterior subtenon injection of 40 mg triamcinolone acetonide at baseline. Patients were reevaluated at 1, 3, 6, and 12 months after injection. RESULTS: Seventy-three injections were performed in 63 eyes of 50 patients. The mean baseline visual acuity was 20/80. Mean visual acuity significantly improved to 20/50 at 1 month, then stabilized to 20/65 at 3 months, 20/68 at 6 months, and 20/63 at 12 months. Complications were rare, with a transient significant rise in intraocular pressure at the 3-month evaluation and ptosis in two patients. CONCLUSIONS: Visual acuities remained stable or improved over a 12-month period after posterior subtenon triamcinolone injections for refractory DME. There was a statistically significant improvement in visual acuity at 1 month.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15733990&dopt=Abstract triamcinolone Kenalog



Kenalog
Does intravitreal triamcinolone acetonide-assisted peeling of the internal limiting membrane effect the outcome of macular hole surgery?

Karacorlu M, Ozdemir H, Arf Karacorlu S.

Istanbul Retina Institute, Inc., Hakki Yeten Cad. No:8/7, Sisli, 34349, Istanbul, Turkey, retina pobox.com.

PURPOSE: To evaluate functional and anatomical outcome of triamcinolone acetonide assisted internal limiting membrane (ILM) peeling in patients with macular hole. METHODS: Fifteen eyes of 15 consecutive patients were identified with stage 3 and 4 idiopathic macular holes, these undergoing triamcinolone acetonide assisted ILM peeling for macular holes. These were matched retrospectively with 15 eyes of 15 patients with stage 3 and 4 idiopathic macular holes of less than six months duration, who underwent macular hole surgery with ILM peel augmented with indocyanine green (ICG). Functional and anatomical outcomes were compared between two groups. RESULTS: There were no significant differences between the two groups with reference to demographic features of age, sex, staging of the macular holes and the proportion subsequently undergoing cataract surgery. The mean follow-up period was 6.4 months in the triamcinolone acetonide group and 7.2 months in the ICG group. The hole closure rate was 100% in both group at primary operation. The mean Snellen line change was +1.24 in the intravitreal triamcinolone group and +1.1 in the ICG group. There was a significant improvement in Snellen and Logmar visual acuity in both groups. These differences in visual outcome between the groups were not statistically significant. CONCLUSIONS: Our data showed similar outcomes for patients with macular hole where ICG has been used when compared to patients where triamcinolone acetonide has been used for ILM peeling. Further study with longer follow-up and large series is warranted to assess the safety of the triamcinolone acetonide assisted ILM peeling in macular hole surgery.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15744526&dopt=Abstract triamcinolone Kenalog



Kenalog
Formulation and efficacy of triamcinolone acetonide mouthwash for treating oral lichen planus.

Ungphaiboon S, Nittayananta W, Vuddhakul V, Maneenuan D, Kietthubthew S, Wongpoowarak W, Phadoongsombat N.

Department of Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkhla, Thailand.

PURPOSE: The stability of a triamcinolone acetonide mouthwash and its efficacy in treating oral lichen planus are described. METHODS: The solubility of triamcinolone acetonide in ethanol, propylene glycol, and glycerin was determined by shaking and equilibrating an excess of triamcinolone acetonide with the solvents for 72 hours. All three solvents were used in formulating a mouthwash. A stock solution of triamcinolone acetonide standard was prepared in ethanol and diluted to yield concentrations of 2, 4, 8, 12, and 16 mug/mL. Analytical sample solutions were prepared by pipetting 0.1 mL of triamcinolone acetonide mouthwash into 10-mL volumetric flasks and diluting to volume with the mobile phase. Accelerated stability studies were conducted by storing the samples in 60-mL amber glass bottles at 45, 60, 70, and 80 degrees C and 75% relative humidity until the triamcinolone concentration decreased markedly. Efficacy was tested by 20 subjects with a clinical diagnosis of and histologically confirmed symptomatic oral lichen planus who were randomized to use the mouthwash (n = 11) or the commercially available triamcinolone acetonide paste (n = 9). RESULTS: The mouthwash had a satisfactory shelf life and was well accepted by patients. Ten of 11 patients treated with the mouthwash for four weeks reported a positive response, and a complete response in signs and symptoms occurred in 4 and 5 of 11 patients, respectively. No significant difference in clinical improvement was observed between groups. CONCLUSION: A triamcinolone acetonide mouthwash had a satisfactory shelf life and was well accepted by patients. It did not have a significantly different therapeutic efficacy from the commercial paste dosage form in the treatment of oral lichen planus.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15745911&dopt=Abstract triamcinolone Kenalog



Kenalog
The efficacy of intravitreal triamcinolone acetonide on macular edema in branch retinal vein occlusion.

Ozkiris A, Evereklioglu C, Erkilic K, Ilhan O.

Erciyes University Medical Faculty, Kayseri - Turkey. aozkiris erciyes.edu.tr

PURPOSE: To evaluate the effectiveness of intravitreal triamcinolone acetonide as primary treatment of macular edema in branch retinal vein occlusion. METHODS: Fifteen eyes of 15 patients with macular edema due to branch retinal vein occlusion (Group 1) who received 8 mg/0.2 ml of intravitreal triamcinolone injection as primary treatment were retrospectively evaluated. The control group (Group 2) consisted of 19 eyes of 19 patients who had received laser treatment for macular edema. The main outcome measures included best-corrected visual acuity, intraocular pressure, and macular edema map values of Heidelberg Retinal Tomograph II. RESULTS: In Group 1, mean visual acuity improved significantly from a mean logMAR (logarithm of minimal angle of resolution) value of 0.98+/-0.19 at baseline to a maximum of 0.24+/-0.24 during a mean follow-up time of 6.3 months. In the control group, the mean baseline log-MAR visual acuity before laser treatment was 1.02+/-0.22, and it was 0.50+/-0.28 at 6-month examinations. Mean improvement in visual acuity at 1-, 3-, and 6-month examinations was significantly higher in Group 1 when compared with the control group (for each, p<0.001). The mean edema map value of Group 1 significantly decreased by 40% at 6-month examinations when compared with preinjection value (p<0.001). In Group 1, mean increase in intraocular pressure elevation was 19.8% at the 1-month, 26.9% at 3-month, and 5.7% at 6-month visits, but intraocular pressures were under control with topical antiglaucomatous medications. CONCLUSIONS: Intravitreal triamcinolone acetonide injection may be a new and promising approach as initial therapy for macular edema due to branch retinal vein occlusion.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15751246&dopt=Abstract triamcinolone Kenalog



Kenalog
Intravitreal triamcinolone acetonide in sympathetic ophthalmia.

Ozdemir H, Karacorlu M, Karacorlu S.

Istanbul Retina Institute Inc., Hakki Yeten Cad., No: 8/7, Sisli, 34349, Istanbul, Turkey, retina pobox.com.

PURPOSE: To report the result of intravitreal triamcinolone acetonide in the treatment of sympathetic ophthalmia. METHODS: A 29-year-old woman who suffered from sympathetic ophthalmia and who was being treated with systemic corticosteroid therapy received an intravitreal injection of 4 mg of triamcinolone acetonide. RESULTS: By the 15th day after injection visual acuity had improved from 20/200 to 20/40 and serous retinal detachment had almost completely resorbed. Systemic corticosteroid therapy was reduced sequentially. By the third month after injection, the patient was in clinical remission. Her visual acuity was 20/20 and no serous detachment was observed. CONCLUSIONS: In this study, short-term improvement in the clinical picture of a patient with sympathetic ophthalmia after intravitreal triamcinolone acetonide injection was described. The results suggest that intravitreal triamcinolone acetonide injection may be an additional tool in the treatment of sympathetic ophthalmia.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15756580&dopt=Abstract triamcinolone Kenalog