Tricort Injections : Information for Patients
	Intravitreal injection of Kenalog/Tricort ™ (triamcinolone acetonide) Information for patients Introduction: Your eye doctor (ophthalmologist) has diagnosed you with an eye condition that causes: • swelling (oedema or inflammation) • leakage from the blood vessels in the eye, and/or • the abnormal growth of blood vessels What is Kenalog™ and its benefits? Kenalog™ (triamcinolone acetonide) is a steroid injected into the jelly or vitreous portion of the eye; we will refer to this type of injection of this drug as IVTA. IVTA reduces the swelling, leakage, and abnormal blood vessel growth, and may improve how well you see. What is “Off-label” status? Kenalog™ (triamcinolone acetonide) is licensed to treat the swelling caused by many medical conditions. According to the manufacturer, it can be injected into a muscle, the skin, or a joint. Once a medication is licensed for use, physicians may use it “off-label” for other purposes if it will benefit their patient. Before doing so, they are expected to know the medication well and have sound medical evidence for its use. Although the drug is not licensed to treat eye conditions, eye doctors have been injecting this medication in and around the eye for over 30 years, since studies have shown that it helps treat eye conditions like yours. There are some serious risks from this type of injection and from the medication itself. The manufacturer has warned doctors about these risks, and to recommend that they not inject them into and around the eye. Despite these known risks and the manufacturer’s warning, it is felt reasonable by most eye doctors to continue to inject it for eye conditions. Your eye doctor feels that this medication is the right one for your condition at this time. Injecting it in your eye instead of giving it as a pill or drops helps to minimize the side effects and maximize the benefits. What are the limitations with this treatment? The goal of treatment is to prevent further loss of vision. Although some patients have regained vision, the medication may not restore vision that has already been lost, and may not ultimately prevent further loss of vision caused by your disease. How is this treatment carried out? After the pupil is dilated and the eye is numbed with local anesthesia, the medication is injected into the vitreous (the jelly-like substance in the back part of the eye). IVTA is given by an injection into your eye as needed. Your eye doctor will tell you how often you will receive the injection, and for how long. Are there any alternatives to this treatment? You do not have to receive IVTA treatment for your condition, although without treatment, diseases like yours can lead to further vision loss and blindness, sometimes very quickly. Your eye doctor will let you know if other medications are available for your condition, whether laser or other types of surgery are the only alternatives, and whether these treatments have already been tried but have not helped your condition. What are the complications from the medication and injection? Your condition may not get better or it may become worse. Any or all of the complications discussed below may cause you to lose vision or cause blindness. Additional medications or procedures, including surgery, may be needed to treat these complications. During the follow up visits or phone calls, you will be checked for possible side effects and the results will be discussed with you. Possible complications and side effects of IVTA include but are not limited to: • retinal detachment, • cataract formation (clouding of the lens of the eye) • glaucoma (increased pressure in the eye) • hypotony (reduced pressure in the eye) • damage to the retina or cornea (structures of the eye) • bleeding There is also the possibility of an eye infection (endophthalmitis). You may receive eye drops with instructions on when to use them to reduce the possibility of this occurring. Any of these rare complications may lead to severe, permanent loss of vision. Patients receiving IVTA may experience less severe side effects related to the pre-injection preparation procedure (eyelid speculum, anesthetic drops, dilating drops, antibiotic drops, povidone-iodine drops and the injection of the anesthetic). These side effects may include: • eye pain • subconjunctival hemorrhage (bloodshot eye) • vitreous floaters • irregularity or swelling of the cornea • inflammation of the eye • visual disturbances If you have any queries or concerns about this treatment please speak to your eye doctor.