Efficacy of Suprachoroidal Triamcinolone Acetonide Injections in Resistant Diabetic Macular Edema

Suprachoroidal Triamcinolone Acetonide in Resistant Diabetic Macular Edema

Authors

  • Vijay Kumar Department of Ophthalmology, Al Ibrahim Eye Hospital, Karachi, Pakistan
  • Nasir Ahmed Memon Department of Ophthalmology, Al Ibrahim Eye Hospital, Karachi, Pakistan
  • Uzma Haseeb Department of Ophthalmology, Al Ibrahim Eye Hospital, Karachi, Pakistan
  • Umer Kazi Isra University, Karachi, Pakistan
  • Shahid Hussain Shah Department of Ophthalmology, Isra Postgraduate Institute of Ophthalmology, Al Ibrahim Eye Hospital, Karachi, Pakistan
  • Abdul Qadeem Department of Ophthalmology, Al Ibrahim Eye Hospital, Karachi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i5.2966

Keywords:

Best Corrected Visual Acuity, Central Subfield Thickness, Corticosteroids, Triamcinolone, Supra-Choroidal Space, Macular Edema

Abstract

Localized drug delivery through the suprachoroidal space can be used for more targeted therapies whilst minimize exposure to the healthy tissues. Objectives: To determine the efficacy of suprachoroidal triamcinolone injection given by the suprachoroidal route in patients with resistant diabetic macular edema. Methods: A quasi-experimental study was done at Al Ibrahim Eye Hospital, Karachi’s Vitreo-retina Department. Duration of research was 6 months (July to December 2024) (ATMC/ERC/13 (01/2023/22). Adult patients attending the vitreo-retinal OPD with resistant diabetic macular edema were included. Data were analyzed using SPSS version 22.0. Discrete variables were reported as mean and standard deviation, and continuous variables as frequencies and percentages.  BCVA and CST readings at 4, 8 and 12 weeks were compared with baseline using a paired t-test, with p-value <0.05 statistically significant. Results: Before injection. The pre- and post SCTA BCVA and CST with baseline mean BCVA were 1.1 ± 0.30, which progressively improved at subsequent follow-ups, reaching 0.33 ± 0.18 by the third month post-injection. Conclusions: SCTA injections significantly improve visual acuity and reduce central subfield thickness in patients over a three-month follow-up period. The progressive enhancement in Best Corrected Visual Acuity and consistent reduction in Central Subfield Thickness highlight the efficacy of SCTA

References

Gamalero L, Simonini G, Ferrara G, Polizzi S, Giani T, Cimaz R. Evidence-based treatment for uveitis. Israel Journal of Medical Sciences. 2019 Jul; 21(7): 475-9.

Kawali AA, Mohan A, Mehta R, Mahendradas P, Srinivasan S, Shetty B. Anti-vascular endothelial growth factor in the treatment of macular edema in epidemic retinitis. Indian Journal of Ophthalmology. 2020 Sep; 68(9): 1912-5. doi: 10.4103/ijo.IJO_439_20.

Lee JY, Lee SY, Kim JY, Lee HJ, Jeong JH, Ma DJ. Effect of alternate treatment with intravitreal anti-vascular endothelial growth factor and steroid for treatment-naive diabetic macular edema in a real-life setting. Journal of Ocular Pharmacology and Therapeutics. 2020 Sep; 36(7): 555-62. doi: 10.1089/jop.2020.0012.

Han JV, Patel DV, Squirrell D, McGhee CN. Cystoid macular oedema following cataract surgery: a review. Clinical and Experimental Ophthalmology. 2019 Apr; 47(3): 346-56. doi: 10.1111/ceo.13513.

Massa H, Pipis SY, Adewoyin T, Vergados A, Patra S, Panos GD. Macular edema associated with non-infectious uveitis: pathophysiology, etiology, prevalence, impact and management challenges. Clinical Ophthalmology. 2019 Sep: 1761-77. doi: 10.2147/OPTH.S180580.

Saidkasimova S. Anatomy and physiology of the suprachoroidal space. Suprachoroidal Space Interventions. 2021: 1-30. doi: 10.1007/978-3-030-76853-9_1.

Shah SS, Haseeb U, Ahmed N, Ahmed I, Ahmed S, Shah SH. Effect of Supra Choroid Triamcinolone Acetate On Intraocular Pressure: Supra Choroid Triamcinolone Acetate for Intraocular Pressure. Pakistan Journal of Health Sciences. 2025 Jan: 152-6. doi: 10.54393/pjhs.v6i1.2087.

Jung JH, Chae JJ, Prausnitz MR. Targeting drug delivery within the suprachoroidal space. Drug Discovery Today. 2019 Aug;24(8): 1654-9. doi: 10.1016/j.drudis.2019.03.027.

Naftali Ben Haim L, Moisseiev E. Drug delivery via the suprachoroidal space for the treatment of retinal diseases. Pharmaceutics. 2021 Jun; 13(7): 967. doi: 10.3390/pharmaceutics13070967.

Ciulla T and Yeh S. Microinjection via the suprachoroidal space: a review of a novel mode of administration. American Journal of Managed Care. 2022 Nov; 28. doi: 10.37765/ajmc.2022.89270.

Wykoff CC, Avery RL, Barakat MR, Boyer DS, Brown DM, Brucker AJ et al. Suprachoroidal Space Injection Technique: Expert Panel Guidance. Retina. 2022 May: 10-97.

Habot‐Wilner Z, Noronha G, Wykoff CC. Suprachoroidally injected pharmacological agents for the treatment of chorio‐retinal diseases: a targeted approach. Acta Ophthalmologica. 2019 Aug; 97(5): 460-72. doi: 10.1111/aos.14042.

Muya L, Kansara V, Cavet ME, Ciulla T. Suprachoroidal injection of triamcinolone acetonide suspension: ocular pharmacokinetics and distribution in rabbits demonstrates high and durable levels in the chorioretina. Journal of Ocular Pharmacology and Therapeutics. 2022 Aug; 38(6): 459-67.

Wu KY, Fujioka JK, Gholamian T, Zaharia M, Tran SD. Suprachoroidal injection: a novel approach for targeted drug delivery. Pharmaceuticals. 2023 Sep; 16(9): 1241. doi: 10.3390/ph16091241.

Hanif J, Iqbal K, Perveen F, Arif A, Iqbal RN, Jameel F et al. Safety and efficacy of suprachoroidal injection of triamcinolone in treating macular edema secondary to noninfectious uveitis. Cureus. 2021 Nov; 13(11). doi: 10.7759/cureus.20038.

Thomas J, Kim L, Albini T, Yeh S. Triamcinolone acetonide injectable suspension for suprachoroidal use in the treatment of macular edema associated with uveitis. Expert Review of Ophthalmology. 2022 May; 17(3): 165-73. doi: 10.1080/17469899.2022.2114456.

Abdelshafy Tabl A, Tawfik Soliman T, Anany Elsayed M, Abdelshafy Tabl M. A randomized trial comparing suprachoroidal and intravitreal injection of triamcinolone acetonide in refractory diabetic macular edema due to epiretinal membrane. Journal of Ophthalmology. 2022; 2022(1): 7947710. doi: 10.1155/2022/7947710.

Jamil MH, Ashraf A, Khan A, Ashraf B, Afzal MB, Shahbaz F. Outcome of Suprachoroidal Triamcinolone Acetonide in Resistant Diabetic Macular Edema: Resistant Diabetic Macular Edema. Pakistan Journal of Health Sciences. 2023 Jul: 74-8. doi: 10.54393/pjhs.v4i07.932.

Nawar AE. Effectiveness of suprachoroidal injection of triamcinolone acetonide in resistant diabetic macular edema using a modified microneedle. Clinical Ophthalmology (Auckland, NZ). 2022 Nov; 16: 3821. doi: 10.2147/OPTH.S391319.

Akhlaq HH, Shah FA, Ahsen M, Hassan SA, Zahid K, Wattoo RR. Efficacy and Safety of Suprachoroidal Administration of Triamcinolone Acetonide in Patients of Refractory Diabetic Macular Edema. Pakistan Journal of Medical and Health Sciences. 2022; 16(11): 592-. doi: 10.53350/pjmhs20221611592.

Bhattacharyya S, Hariprasad SM, Albini TA, Dutta SK, John D, Padula WV et al. Suprachoroidal injection of triamcinolone acetonide injectable suspension for the treatment of macular edema associated with uveitis in the United States: a cost-effectiveness analysis. Value in Health. 2022 Oct; 25(10): 1705-16. doi: 10.1016/j.jval.2022.07.008.

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Published

2025-05-31
CITATION
DOI: 10.54393/pjhs.v6i5.2966
Published: 2025-05-31

How to Cite

Kumar, V., Memon, N. A., Haseeb, U., Kazi, U., Shah, S. H., & Qadeem, A. (2025). Efficacy of Suprachoroidal Triamcinolone Acetonide Injections in Resistant Diabetic Macular Edema: Suprachoroidal Triamcinolone Acetonide in Resistant Diabetic Macular Edema. Pakistan Journal of Health Sciences, 6(5), 297–301. https://doi.org/10.54393/pjhs.v6i5.2966

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