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Intravitreal Steroids as a Surgical Adjunct

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Intravitreal Steroids

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Abstract

Due to their powerful anti-inflammatory characteristics, steroids play a key role before, during, and after ophthalmic surgery. During surgery they are also useful to better visualize the vitreous, as a non-colorant precipitating staining agent in uncomplicated membrane peeling and in sustained-release delivery modes in intraocular inflammatory diseases. Alone or in combination, they inhibit the pathway leading to a strong inflammatory response after surgery. Their therapeutic use remains invaluable in the treatment of inflammatory pathologies such as uveitis.

For many years, an injectable intramuscular suspension of triamcinolone acetonide was adapted for ophthalmic use because no ophthalmic formulation was commercially available. Recently, injectable suspensions have become available for intravitreal injection in sympathetic ophthalmia, temporal arteritis, uveitis, and ocular inflammatory conditions unresponsive to topical corticosteroids. A sustained-release dexamethasone intravitreal implant has received approval for the treatment of macular edema following BRVO and CRVO, for the treatment of noninfectious uveitis affecting the posterior segment, as well as the treatment of visual impairment due to diabetic macular edema in pseudophakic patients or patients not suitable for non-corticoid therapy. Fluocinolone acetonide intravitreal implants have been approved for the treatment of chronic noninfectious uveitis affecting the posterior segment or treatment of vision impairment associated with chronic DME insufficiently responsive to other available therapies.

Widening therapeutic indications and the availability of new longer-lasting sustained-release delivery modes for corticosteroids will lead to new approaches to treat the widest possible range of ocular diseases, along with significant lowering of health-care costs for both patients and institutions.

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Authors and Affiliations

  1. Department of Neuroscience, Azienda Ospedaliera Universitaria Pisana, Viaparadisa n 2, Pisa, 56124, Italy

    Stanislao Rizzo MD

  2. Chirurgia Oftalmica, Azienda Ospedaliera Universitaria Pisana, via Paradisa n 2, Pisa, 56124, Italy

    Tomaso Caporossi & Francesco Barca MD

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  1. Stanislao Rizzo MD
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  2. Tomaso Caporossi
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  3. Francesco Barca MD
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Correspondence to Tomaso Caporossi .

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Editors and Affiliations

  1. Städt. Klinikum Karlsruhe, Augenklinik, Karlsruhe, Germany

    Albert J. Augustin

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Rizzo, S., Caporossi, T., Barca, F. (2015). Intravitreal Steroids as a Surgical Adjunct. In: Augustin, A. (eds) Intravitreal Steroids. Springer, Cham. https://doi.org/10.1007/978-3-319-14487-0_9

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  • DOI: https://doi.org/10.1007/978-3-319-14487-0_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-14486-3

  • Online ISBN: 978-3-319-14487-0

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