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

The electronic version of this article is the complete one and can be found online at:

Published: September 22, 2004

© 2004 Kube et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




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.


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).


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.


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.