Suprachoroidal Space Triamcinolone Acetonide: A Review in Uveitic Macular Edema

Abstract

Triamcinolone acetonide injectable suspension for suprachoroidal use (Xipere^®; SCS triamcinolone acetonide) is a corticosteroid approved in the USA for the treatment of macular edema associated with uveitis. Suprachoroidal injection of SCS triamcinolone acetonide results in preferential distribution into the posterior segment, which may reduce the risk of corticosteroid-related adverse events, such as cataracts and intraocular pressure (IOP) elevation. In a multicenter phase III trial in patients with non-infectious uveitic macular edema, SCS triamcinolone acetonide significantly and rapidly improved visual acuity and reduced signs of macular edema compared with sham treatment. SCS triamcinolone acetonide was generally well tolerated, with the most common adverse event being eye pain on the day of the procedure. The risk of corticosteroid-related IOP elevation appeared to be reduced in unrescued patients in the SCS triamcinolone acetonide group compared with patients in the sham control group who received rescue therapy. SCS triamcinolone acetonide is a novel and useful treatment option for uveitic macular edema.

Fig. 1

Most common (incidence ≥ 5% in either treatment group) ocular adverse events in the 24-week PEACHTREE trial [15]. IOP intraocular pressure, SCS-TA triamcinolone acetonide formulated for injection into the suprachoroidal space. ^aIOP elevation includes: IOP increase, ocular hypertension and glaucoma; was defined as a > 10 mmHg increase from baseline measurements or a total of ≥ 30 mmHg. ^bAll corticosteroid-related IOP elevation in the sham group occurred following corticosteroid use from rescue therapy. Φ indicates an incidence of 0%.