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Hypothalamic-pituitary-adrenal axis function following intravitreal triamcinolone acetonide injection
Maoz D Amiran1, Sonia N Yeung, Yaron Lang
1Department of Ophthalmology, Ha'Emek Medical Center, 18101, Afula, Israel. karen_charrach@hotmail.com
A single intravitreal injection of triamcinolone acetonide (IVTA) may temporarily impair the hypothalamic-pituitary-adrenal axis. Adrenocorticotropic hormone (ACTH) stimulation tests showed blunted cortisol responses in some patients within 24 hours post-injection.
Area of Science:
- Endocrinology
- Ophthalmology
Background:
- Intravitreal triamcinolone acetonide (IVTA) is used to treat macular edema.
- The effect of IVTA on the pituitary-adrenal axis requires further investigation.
Purpose of the Study:
- To assess the impact of a single IVTA injection on pituitary-adrenal axis function.
Main Methods:
- A prospective study involving 28 patients with macular edema receiving IVTA.
- Adrenocorticotropic hormone (ACTH) stimulation tests were performed before and at various time points after IVTA.
- Results were compared to a control group of 50 healthy subjects.
Main Results:
- One day post-IVTA, basal cortisol was suppressed in one patient.
- Cortisol response to ACTH stimulation was blunted at 30 min (14.3%) and suppressed at 60 min (p=0.009) in some patients.
- Pituitary-adrenal function normalized by 1 week in most patients.
Conclusions:
- A single IVTA injection can transiently impair hypothalamic-pituitary-adrenal axis function.
- The most significant impact was observed within the first 24 hours after injection.
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