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Triamcinolone acetonide in cellular membrane may produce cytotoxicity
Retina. 2011;31(10):2050-2057
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Retinal cytotoxicity may occur when there is close contact between triamcinolone acetonide crystals and the cellular membrane, a study found.
The researchers evaluated a preservative containing triamcinolone acetonide, compounded preservative-free triamcinolone acetonide and preservative-free triamcinolone acetonide injectable suspension. The various formulations were added to cell cultures or separated by a Boyden chamber filter or a layer of vitreous. The cultures included retinal pigment epithelial cells or retinal ganglion cells. Crystal distribution patterns were assessed microscopically.
Sedimentation of triamcinolone acetonide generally caused a decrease in cell viability, with cytotoxicity more prevalent for the injectable suspension and preservative-free formulations.
Larger and more numerous crystal aggregates tend to be associated with increased cytotoxicity because they are more prone to sink downward, the study authors said. Of the formulations tested, triamcinolone acetonide injectable suspension had the strongest tendency to form large crystal conglomerates.
While the vitreous scaffold and the internal limiting membrane often protect against cytotoxicity, membrane peeling or extensive retinal manipulation may inhibit such protection. Consequently, vitreoretinal surgeons should thoroughly remove triamcinolone acetonide remnants, the researchers said.