triamcinolone benetonide (Benecorten / Curdem / Tibicorten)

Safety and Effectiveness of Placental Connective Tissue Matrix Allograft Versus Corticosteroid Injection in Adhesive Capsulitis: A Double-Blinded Prospective Randomized Study.

Nembhard Olivia C OC, Pogoda Janice M JM, Helm James M JM, Gregory James M JM et al.

Adhesive capsulitis causes significant pain and functional limitation, with limited effective treatment options. Current standard-of-care treatments, such as corticosteroid injections, may offer short-term symptom relief but are associated with limited long-term efficacy and potential side effects. Regenerative therapies using extracellular matrix-based products derived from placental tissue have shown promise in treating musculoskeletal injuries due to their anti-inflammatory and tissue-healing properties. Clinical data supporting their use in adhesive capsulitis remains limited. The objective of this study was to compare the safety and effectiveness of a flowable placental connective tissue matrix allograft (PCTMA) vs. corticosteroid injection for adhesive capsulitis. We hypothesized that intra-articular injection of a placental connective tissue allograft would result in superior clinical outcomes compared with corticosteroid injection for adhesive capsulitis of the shoulder. Randomized controlled clinical trial. This double-blinded prospective study randomized patients with adhesive capsulitis to receive either intra-articular PCTMA (1 cc) with lidocaine (study group, n = 25) or corticosteroid injection with triamcinolone 20 mg and lidocaine (control group, n = 27). Inclusion criteria included ages 18 to 75 years, clinical diagnosis of adhesive capsulitis, shoulder pain >6 weeks, and MRI confirmation without other shoulder pathology. The primary end point was change from baseline in Shoulder Pain and Disability Index (SPADI) score. Secondary end points included Visual Analog Scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, and passive range of motion. Assessments occurred at 4, 12, and 24 weeks postinjection. Both groups improved over time. At 24 weeks, mean SPADI improvement was similar between groups [PCTMA: -40.4 (SD 18.81) vs. corticosteroid: -37.7 (SD 30.12)] (p = 0.73), but post hoc responder analyses favored PCTMA: SPADI responders 88% vs. 63% (p = 0.04), VAS responders 80% vs. 56% (p = 0.06), and ASES responders 88% vs. 56% (p = 0.01). One serious adverse event unrelated to the study intervention was reported. Flowable intra-articular PCTMA demonstrated a favorable safety profile and comparable improvements in pain and disability to corticosteroid injection at 24 weeks. A post hoc responder analysis favored PCTMA, suggesting potential for more sustained clinical benefit warranting further investigation. This study provides the first randomized controlled comparison of PCTMA vs. corticosteroid injection for adhesive capsulitis, offering preliminary evidence to guide treatment selection and informing the design of future, larger-scale trials investigating biologic therapies for this condition. The authors confirm that the protocol was finalized before patient enrollment. Clinical trial registration (NCT05844930) was completed in April 2023. Therapeutic Level II.See Instructions for Authors for a complete description of levels of evidence.

Subconjunctival triamcinolone acetate versus topical steroid for control of inflammation after phacoemulsification surgery - A randomized control trial.

Moond Harshita H, Sethi Neha K NK, Kaur Gagandeep G, Kaur Harnoor H et al.

To compare the efficacy of subconjunctival triamcinolone versus topical prednisolone in controlling postoperative inflammation after phacoemulsification. In this randomized control study, a total of 100 eyes were enrolled. Patients with age-related cataract undergoing phacoemulsification under peribulbar anesthesia were randomly allocated into two groups using a computer-generated random table. Group A received single-dose subconjunctival triamcinolone acetonide (20 mg/0.5 ml) at the end of surgery; Group B received topical prednisolone 1% eyedrops in tapering doses for 1.5 months. Patients were followed up on postoperative days 1, 7, 21, and 42 for anterior chamber (AC) cells, flare, intraocular pressure (IOP), subconjunctival hemorrhage, and cystoid macular edema using optical coherence tomography (OCT). SPSS version 20.0, Chi-square, and t-tests were applied for statistical analysis. A P value < 0.05 was considered statistically significant. There was no significant difference in AC cells, flare, and mean IOP between both groups on any postoperative day. Three patients had extensive AC inflammation for 5-7 days. Pressure spikes >25 mmHg were noted in four patients in Group A and three patients in Group B ( P value = 0.69). Subconjunctival hemorrhage was significantly more in Group A (P 0.001) on days 1 and 7, which resolved in all patients by 21 days. There was no significant difference in central subfoveal thickness on OCT in both groups on day 42. All the patients had good postoperative gain in visual acuity. A few patients complained of mild cosmetic blemish from steroid deposit. Subconjunctival triamcinolone is noninferior to topical steroids in controlling post-phacoemulsification intraocular inflammation.

Local therapy in uveitis: Current concepts and emerging strategies.

Jain Tanya T, Goel Pallavi P, Agarwal Manisha M

Local therapy plays a pivotal role in the management of noninfectious uveitis, providing targeted drug delivery with reduced systemic adverse effects. Advances in corticosteroid formulations and delivery routes have significantly improved therapeutic outcomes. Topical corticosteroids remain first-line for anterior uveitis, while periocular and intravitreal injections such as triamcinolone acetonide and dexamethasone implants (Ozurdex®) are effective for intermediate and posterior disease. Long-acting fluocinolone acetonide implants (Retisert®, Yutiq®) offer sustained control for chronic or recurrent cases, though ocular hypertension and cataract formation are common. The introduction of suprachoroidal corticosteroid delivery (Xipere®) allows precise posterior segment targeting with fewer anterior complications. Nonsteroidal intravitreal agents, including methotrexate and sirolimus, serve as steroid-sparing options, and topical immunomodulators such as cyclosporine and tacrolimus can be rarely used in chronic anterior uveitis. Emerging modalities like intravitreal biologics, nanocarrier systems, and gene-based delivery hold promise for long-term disease modulation. A tailored, evidence-based approach to local therapy can optimize inflammation control and visual outcomes in uveitis management.

Herpes zoster-associated cutaneous vasculitis following intra-articular triamcinolone acetonide injection in an immunocompetent patient.

Rajagopal Dhiren R DR, Anand Dipti D, Babcock Melissa D MD