gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Efficacy of different preparations of Triamcinolone acetonide for intravitreal injection

Meeting Abstract

  • corresponding author T. Kube - Universitäts-Augenklinik, Freiburg
  • M. Sutter - Apotheke des Universitätsklinikums, Freiburg
  • L.L. Hansen - Universitäts-Augenklinik, Freiburg
  • R. Trittler - Apotheke des Universitätsklinikums, Freiburg
  • L. Hauser - Apotheke des Universitätsklinikums, Freiburg
  • H.T. Agostini - Universitäts-Augenklinik, Freiburg

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogFR.04.10

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dog2004/04dog197.shtml

Veröffentlicht: 22. September 2004

© 2004 Kube et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Intravitreal injection of triamcinolone acetonide has become increasingly popular for the treatment of a variety of intraocular disorders. The concentrations used range from 4 to 25mg/0,2ml. Three different preparations have been described so far: (A) Injection with preservative after sedimentation, or micro-filtration via (B) three-way valve or, (C) reverse flow.

Methods

Commercially available triamcinolone acetonide (Volon A) was processed according to the different preparation guidelines and the concentrate was transferred into a syringe for transportation. Each concentrate was loaded into a sterile tuberculin syringe prior to the injection into an eye-model. Concentrations of triamcinolone acetonide and benzalkonium chloride were assessed quantitatively and with high-pressure liquid chromatography (HPLC).

Results

The concentrations of triamcinolone acetonide in the transport syringes ranged in all preparations from 93±6,7% to 106±5,4% of the target concentration. Benzalkonium chloride was found in large amounts in (A), but not in (B) or (C). After injection into the eye-model, the concentration of triamcinolone acetonide was reduced to 15,4±14% of the target concentration with preparation (B) and 11,3±12% with preparation (C), respectively. Benzalkonium chloride was not detected. Following method (A) a concentration of 45,1±16,2% could be measured with large amounts of benzalkonium chloride. A significant portion of the crystalline drug was found on the inner wall of both syringes and cannulas.

Conclusions

The different methods of preparations (A-C) of triamcinolone acetonide crystals for intravitreal injection produce a high rate of retrieval for the active drug. After transfer into a sterile syringe a significant portion of the crystals gets lost. As a result, the final concentration of the steroid varies. Benzalkonium chloride augments the solubility of triamcinolone acetonide crystals. However, contamination with this preservative is not desired because of its assumed retinotoxic effect.