Safety of high-dose intravitreal triamcinolone acetonide as low-cost alternative to anti-vascular endothelial growth factor agents in lower-middle-income countries

Hammouda Hamdy Ghoraba,1,2 Mahmoud Leila,3 Sameh Mohamed Elgouhary,4 Emad Eldin Mohamed Elgemai,2,5 Haithem Mamon Abdelfattah,2,6 Hashem Hammouda Ghoraba,2 Mohamed Amin Heikal7 1Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt; 2Department of Retina, Magrabi Eye Hosp...

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Autores principales:	Ghoraba HH, Leila M, Elgouhary SM, Elgemai EEM, Abdelfattah HM, Heikal MA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	High-dose IVTA Cost-effectiveness of anti-VEGF ICER of anti-VEGF per QALY Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/68d3265cbf0d40ed99029c86a5fab91f
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spelling	oai:doaj.org-article:68d3265cbf0d40ed99029c86a5fab91f2021-12-02T06:24:38ZSafety of high-dose intravitreal triamcinolone acetonide as low-cost alternative to anti-vascular endothelial growth factor agents in lower-middle-income countries1177-5483https://doaj.org/article/68d3265cbf0d40ed99029c86a5fab91f2018-11-01T00:00:00Zhttps://www.dovepress.com/safety-of-high-dose-intravitreal-triamcinolone-acetonide-as-low-cost-a-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Hammouda Hamdy Ghoraba,1,2 Mahmoud Leila,3 Sameh Mohamed Elgouhary,4 Emad Eldin Mohamed Elgemai,2,5 Haithem Mamon Abdelfattah,2,6 Hashem Hammouda Ghoraba,2 Mohamed Amin Heikal7 1Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt; 2Department of Retina, Magrabi Eye Hospital, Tanta, Egypt; 3Retina Department, Research Institute of Ophthalmology, Giza, Egypt; 4Department of Ophthalmology, Faculty of Medicine, Menoufia University, Menoufia, Egypt; 5Department of Ophthalmology, Damanhour Teaching Hospital, Damanhour, Egypt; 6Department of Ophthalmology, Banha Teaching Hospital, Banha, Egypt; 7Department of Ophthalmology, Faculty of Medicine, Benha University, Benha, Egypt Purpose: The purpose of this study was to evaluate the safety of high-dose intravitreal triamcinolone acetonide (IVTA) as affordable low-cost alternative to anti-vascular endothelial growth factor (anti-vascular endothelial growth factor [anti-VEGF] agents) in lower-middle-income countries.Patients and methods: This was a retrospective interventional non-comparative case series. The study recruited patients who received 20 mg IVTA for treating various retinal and optic nerve diseases over the past 5 years. Main outcome measure was assessment of complications secondary to high-dose IVTA. The crosstabs procedure was used to display the interaction between the variables tested. The ANOVA test was used to analyze the differences among group means.Results: The study included 207 eyes of 168 patients. The main indication for high-dose IVTA were diabetic macular edema 64%, and macular edema secondary to retinal vein occlusion 19%. The mean follow-up period post-injection was 22 months. Mean number of injections was 1.3. Cataract developed in 54% of eyes. Glaucoma developed in 18.5% of eyes. Glaucoma surgery for intractable glaucoma attributed to high-dose IVTA was needed in 1% of eyes. Endophthalmitis and retinal detachment developed in one patient each.Conclusion: High-dose IVTA is a safe and cost-effective alternative to anti-VEGF agents. Cataract formation and intraocular pressure rise do not pose major adverse effects when weighed against the risk of vision loss due to inability to afford anti-VEGF treatment. Keywords: high-dose IVTA, cost-effectiveness of anti-VEGF, ICER of anti-VEGF per QALY Ghoraba HHLeila MElgouhary SMElgemai EEMAbdelfattah HMGhoraba HHHeikal MADove Medical PressarticleHigh-dose IVTACost-effectiveness of anti-VEGFICER of anti-VEGF per QALYOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 12, Pp 2383-2391 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	High-dose IVTA Cost-effectiveness of anti-VEGF ICER of anti-VEGF per QALY Ophthalmology RE1-994
spellingShingle	High-dose IVTA Cost-effectiveness of anti-VEGF ICER of anti-VEGF per QALY Ophthalmology RE1-994 Ghoraba HH Leila M Elgouhary SM Elgemai EEM Abdelfattah HM Ghoraba HH Heikal MA Safety of high-dose intravitreal triamcinolone acetonide as low-cost alternative to anti-vascular endothelial growth factor agents in lower-middle-income countries
description	Hammouda Hamdy Ghoraba,1,2 Mahmoud Leila,3 Sameh Mohamed Elgouhary,4 Emad Eldin Mohamed Elgemai,2,5 Haithem Mamon Abdelfattah,2,6 Hashem Hammouda Ghoraba,2 Mohamed Amin Heikal7 1Department of Ophthalmology, Faculty of Medicine, Tanta University, Tanta, Egypt; 2Department of Retina, Magrabi Eye Hospital, Tanta, Egypt; 3Retina Department, Research Institute of Ophthalmology, Giza, Egypt; 4Department of Ophthalmology, Faculty of Medicine, Menoufia University, Menoufia, Egypt; 5Department of Ophthalmology, Damanhour Teaching Hospital, Damanhour, Egypt; 6Department of Ophthalmology, Banha Teaching Hospital, Banha, Egypt; 7Department of Ophthalmology, Faculty of Medicine, Benha University, Benha, Egypt Purpose: The purpose of this study was to evaluate the safety of high-dose intravitreal triamcinolone acetonide (IVTA) as affordable low-cost alternative to anti-vascular endothelial growth factor (anti-vascular endothelial growth factor [anti-VEGF] agents) in lower-middle-income countries.Patients and methods: This was a retrospective interventional non-comparative case series. The study recruited patients who received 20 mg IVTA for treating various retinal and optic nerve diseases over the past 5 years. Main outcome measure was assessment of complications secondary to high-dose IVTA. The crosstabs procedure was used to display the interaction between the variables tested. The ANOVA test was used to analyze the differences among group means.Results: The study included 207 eyes of 168 patients. The main indication for high-dose IVTA were diabetic macular edema 64%, and macular edema secondary to retinal vein occlusion 19%. The mean follow-up period post-injection was 22 months. Mean number of injections was 1.3. Cataract developed in 54% of eyes. Glaucoma developed in 18.5% of eyes. Glaucoma surgery for intractable glaucoma attributed to high-dose IVTA was needed in 1% of eyes. Endophthalmitis and retinal detachment developed in one patient each.Conclusion: High-dose IVTA is a safe and cost-effective alternative to anti-VEGF agents. Cataract formation and intraocular pressure rise do not pose major adverse effects when weighed against the risk of vision loss due to inability to afford anti-VEGF treatment. Keywords: high-dose IVTA, cost-effectiveness of anti-VEGF, ICER of anti-VEGF per QALY
format	article
author	Ghoraba HH Leila M Elgouhary SM Elgemai EEM Abdelfattah HM Ghoraba HH Heikal MA
author_facet	Ghoraba HH Leila M Elgouhary SM Elgemai EEM Abdelfattah HM Ghoraba HH Heikal MA
author_sort	Ghoraba HH
title	Safety of high-dose intravitreal triamcinolone acetonide as low-cost alternative to anti-vascular endothelial growth factor agents in lower-middle-income countries
title_short	Safety of high-dose intravitreal triamcinolone acetonide as low-cost alternative to anti-vascular endothelial growth factor agents in lower-middle-income countries
title_full	Safety of high-dose intravitreal triamcinolone acetonide as low-cost alternative to anti-vascular endothelial growth factor agents in lower-middle-income countries
title_fullStr	Safety of high-dose intravitreal triamcinolone acetonide as low-cost alternative to anti-vascular endothelial growth factor agents in lower-middle-income countries
title_full_unstemmed	Safety of high-dose intravitreal triamcinolone acetonide as low-cost alternative to anti-vascular endothelial growth factor agents in lower-middle-income countries
title_sort	safety of high-dose intravitreal triamcinolone acetonide as low-cost alternative to anti-vascular endothelial growth factor agents in lower-middle-income countries
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/68d3265cbf0d40ed99029c86a5fab91f
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Safety of high-dose intravitreal triamcinolone acetonide as low-cost alternative to anti-vascular endothelial growth factor agents in lower-middle-income countries

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