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Intravitreal Triamcinolone Beats Periocular Tx for Macular Edema

MONDAY, Oct. 1, 2018 -- For patients with uveitic macular edema (ME), intravitreal triamcinolone acetonide (ITA) and intravitreal dexamethasone implant (IDI) are superior to periocular triamcinolone acetonide (PTA), according to a study published online Sept. 27 in Ophthalmology.

Jennifer E. Thorne, M.D., Ph.D., from the Johns Hopkins University School of Medicine in Baltimore, and colleagues conducted a multicenter trial involving patients with uveitic ME. Patients were randomized in a 1:1:1 ratio to receive PTA, ITA, or IDI. The proportion of baseline (PropBL) central subfield thickness (CST) at eight weeks was assessed as the primary outcome.

The researchers found that during follow-up, all treatment groups demonstrated improved CST. Relative to baseline, each group had clinically meaningful reductions in CST at eight weeks (PropBL, 0.77, 0.61, and 0.54, respectively). Larger reductions were seen in CST for ITA and IDI versus PTA (hazard ratios, 0.79 and 0.69, respectively); IDI was noninferior to ITA at eight weeks. IDI and ITA treatments were superior to PTA for improving and resolving uveitic ME. The risk of having intraocular pressure ≥24 mm Hg was increased in the intravitreal versus the periocular group, with no significant difference between the intravitreal groups.

"Intravitreal triamcinolone acetonide and the IDI were superior to PTA for treating uveitic ME with modest increases in the risk of intraocular pressure elevation," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Allergan, which donated a limited supply of dexamethasone implants for participants.

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Posted: October 2018

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