Steroids, having both anti-inflammatory and anti-angiogenic properties, are a useful therapeutic option in the treatment of retinal disease. Intravitreal steroids can be used in the treatment of various retinal conditions including diabetic and vasculo-occlusive macular edema, exudative macular degeneration, pseudophakic cystoid macular edema, and posterior uveitis. Although there are well known serious potential complications with intravitreal steroids, including glaucoma and endophthalmitis, recent studies have shown that intravitreal steroids may be used as a safe alternative to the practice of laser therapy for the treatment of macular edema secondary to diabetes or vein occlusions. Although there are several steroid formulations that may be used, this article focuses on the use of intravitreal dexamethasone. Dexamethasone is a potent anti-inflammatory agent that inhibits multiple inflammatory cytokines. Despite its established therapeutic benefit, side effects such as cataract formation and ocular hypertension/glaucoma raise concerns. Therefore, understanding the molecular and genetic effects of intraocular steroid treatments is of utmost importance and of clinical relevance. Our in vivo studies have elucidated several genes and pathways that are potentially altering the neuroprotective and/or neurodegenerative balance between glial and retinal ganglion cells during intravitreal steroid treatment, such as semaphorin signaling, a member of the neuronal axonal guidance signaling system. Furthermore, our more recent data results suggests that dexamethasone affects the balance of Th1, Th2 and Th17 cytokine production, which influences many pathological processes and plays both causative and protective roles in retinal disease.
|Original language||English (US)|
|Title of host publication||Dexamethasone: Therapeutic Uses, Mechanism of Action and Potential Side Effects|
|Publisher||Nova Science Publishers, Inc.|
|Number of pages||30|
|State||Published - 2013|
ASJC Scopus subject areas
- Pharmacology, Toxicology and Pharmaceutics(all)