Triamcinolone Acetonide Kenalog Injection

Topical corticosteroids do not readily penetrate the posterior segment, and posterior sub-Tenon s steroid injections take a long time to diffuse into the posterior segment. Direct placement of corticosteroids into the vitreous cavity may be the best way to deliver corticosteroids to the posterior segment and minimize systemic side effects (16). 

The appropriate intravitreal triamcinolone dose has not yet been established. The ISIS study compares 2 mg versus 4 mg of triamcinolone in patients with macular edema. Preliminary data indicates that the 4 mg dose is more effective at treating macular edema (30). Two studies by Jonas et al. (32,33) in Europe, demonstrated measurable vitreous triamcinolone for seven to eight months and 1.5 years, respectively, after an injection of 20 25 mg of the drug. Prospective trials that compare the 20 25 mg dose to lower doses will be necessary to clarify the optimal dosing regimen. 

Intravitreal injections to deliver corticosteroids minimize systemic side effects however, they may be associated with complications such as retinal detachment, retinal tears, vitreous hemorrhage, endophthalmitis, increased intraocular pressure (IOP), cataract formation, and, with repeated use (required for successful treatment), fibrosis and ptosis. The most common side effect is increased IOP, which has been found on rare occasion to increase drastically (up to 50mmHg in one case report by Detry-Morel et al.) (16,34,35). Close IOP monitoring is crucial following intravitreal injection. 

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Kenalog Triamcinolone acetonide Bristol-Myers Squibb Off-label use Wet AMD, DME, Uveitis Intravitreal injection... 

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