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July 2004

Intravitreal Injection of Triamcinolone for Diffuse Macular Edema

Arch Ophthalmol. 2004;122(7):1085-1086. doi:10.1001/archopht.122.7.1085

We read with great interest the recent article by Jonas et al1 in the January 2003 issue of the ARCHIVES. Becauseof the authors' statement that eyes can tolerate intravitreal triamcinoloneacetonide doses of 25 mg, we decided to evaluate, through the National Institutesof Health, Bethesda, Md, hospital pharmacy, the authors' published techniques2,3 to reduce the solvent agent,primarily benzyl alcohol, from a commercially prepared triamcinolone acetonidesuspension (Volon A 40, 40 mg/mL; Bristol-Myers Squibb, Munich, Germany).We used a triamcinolone acetonide suspension commercially available in theUnited States (Kenalog-40, 40 mg/mL; Bristol-Myers Squibb, Princeton, NJ),which, according to the manufacturer (T. Douglas, Bristol-Myers Squibb, Munich,oral communication, August 8, 2003), is identical to Volon A 40. Triamcinoloneand benzyl alcohol quantification was performed using high-performance liquidchromatography (HPLC) methods.4 Differentsyringe-driven filter units were evaluated including a Millipore filter (Millex-SV5-µm pore size; Millipore Co, Billerica, Mass) available in the UnitedStates and the Sterifix Pury filter (5-µm pore size; B. Braun MelsungenAG, Melsungen, Germany) described in the authors' original methods,2 as well as 2 filters commonly used in ophthalmicsurgery: the Visitec 1030 high-flow 0.20-µm filter (Visitec Co, Sarasota,Fla) and the SurgPlus 0.22-µm filter (Cooper Vision, Fairport, NY).

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