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Review
. 2014 Jan 8:2014:989501.
doi: 10.1155/2014/989501. eCollection 2014.

Intravitreal steroids for the treatment of retinal diseases

Valentina Sarao  1 , Daniele Veritti  1 , Francesco Boscia  2 , Paolo Lanzetta  1
Affiliations
Review

Intravitreal steroids for the treatment of retinal diseases

Valentina Sarao et al. ScientificWorldJournal. .

Abstract

Diabetic macular edema (DME), pseudophakic cystoid macular edema (CME), age-related macular degeneration (AMD), retinal vascular occlusion (RVO), and uveitis are ocular conditions related to severe visual impairment worldwide. Corticosteroids have been widely used in the treatment of these retinal diseases, due to their well-known antiangiogenic, antiedematous, and anti-inflammatory properties. Intravitreal steroids have emerged as novel and essential tools in the ophthalmologist's armamentarium, allowing for maximization of drug efficacy and limited risk of systemic side effects. Recent advances in ocular drug delivery methods led to the development of intraocular implants, which help to provide prolonged treatment with controlled drug release. Moreover, they may add some potential advantages over traditional intraocular injections by delivering certain rates of drug directly to the site of action, amplifying the drug's half-life, contributing in the minimization of peak plasma levels of the drug, and avoiding the side effects associated with repeated intravitreal injections. The purpose of this review is to provide an update on the use of intravitreal steroids as a treatment option for a variety of retinal diseases and to review the current literature considering their properties, safety, and adverse events.

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Figures

Figure 1
Figure 1
Distribution of change in visual acuity (ETDRS letters) between baseline and month 12 (unless otherwise specified) for large, controlled, and randomized clinical trials investigating steroids in diabetic macular edema and macular edema secondary to retinal vein occlusion. GENEVA (6 months): 700 µg dexamethasone implant. SCORE: 4 mg intravitreal triamcinolone acetonide. DRCR prot B: 4 mg intravitreal triamcinolone acetonide. DRCR prot I: 4 mg intravitreal triamcinolone acetonide plus laser photocoagulation. FAME (24 months): 0.2 μg/day fluocinolone implant. GENEVA and FAME publications did not disclose distribution of change other than the percentage of patients showing a ≥ 15 ETDRS letters gain.
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