Ratra Dhanashree, Ratra Vineet, Shah Haard
Department of Vitreoretinal Diseases, Medical Research Foundation, Sankara Nethralaya, 41, College Road, Chennai, 600006, India.
Department of Comprehensive Ophthalmology, Medical Research Foundation, Sankara Nethralaya, 41, College Road, Chennai, 600006, India.
BMC Ophthalmol. 2018 Jun 20;18(1):145. doi: 10.1186/s12886-018-0818-y.
We report occurrence of peculiar tiny white thread like vitreous opacities after intravitreal triamcinolone injection. These persisted without any change for over a year. We ascribe them to aggregation of triamcinolone crystals due to the purification methods.
Seven patients (8 eyes) with macular edema developed tiny whitish thread like opacities in the vitreous 2-3 months after undergoing an intravitreal injection of triamcinolone acetonide preparation containing benzyl alcohol as preservative. These opacities persisted unchanged for more than a year. The follow up ranged from 91 to 425 days. Vitreous tap was done in one patient which was negative for infection. All patients initially showed improvement but needed re-treatment for recurrence. One patient developed steroid induced rise in intraocular pressure. Microscopic examination of the drug revealed large string like aggregates of triamcinolone crystals.
We hypothesize the possibility of aggregation of triamcinolone crystals into string like structures probably due to the purification methods used during manufacture which led to these thread like opacities in the vitreous.
我们报告了玻璃体内注射曲安奈德后出现特殊的微小白色线状玻璃体混浊。这些混浊持续一年多未发生任何变化。我们将其归因于纯化方法导致的曲安奈德晶体聚集。
7例（8只眼）黄斑水肿患者在玻璃体内注射含有苯甲醇作为防腐剂的曲安奈德丙酮制剂后2 - 3个月，玻璃体中出现微小的白色线状混浊。这些混浊持续一年多未变。随访时间为91至425天。对1例患者进行了玻璃体穿刺，结果显示无感染。所有患者最初均有改善，但复发后需要再次治疗。1例患者出现类固醇诱导的眼压升高。对药物进行显微镜检查发现曲安奈德晶体形成大的串状聚集体。
我们推测曲安奈德晶体可能聚集成串状结构，这可能是由于生产过程中使用的纯化方法导致玻璃体中出现这些线状混浊。
