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Diabetic macular edema before and after intravitreal triamcinolone injection.

AbstractPURPOSE:
To compare intravitreal triamcinolone acetonide (IVT) versus natural course in refractory diabetic macular edema.
METHODS:
In a prospective interventional case series, twenty five eyes with refractory DME which had been allocated to the sham group of a previous clinical trial underwent new examination and optical coherence tomography about 9 months after their first enrollment. Twenty eyes that met the inclusion criteria, visual acuity (VA) < 20/50 and central macular thickness (CMT) > 200 microm, were treated by 4 mg IVT. Evaluations were repeated at 2 and 4 months post-injection to imitate the similar examination intervals after sham injection. Corrected visual acuity and macular thickness changes following IVT were compared to the corresponding changes after sham injection (the natural course).
RESULTS:
Visual acuity changes within and between each period were not statistically significant. Visual acuity decreased 0.08 & 0.09 logMAR by 2 months and 0.06 & 0.04 logMAR by 4 months after sham and IVT injections, respectively. The changes of macular thickness after IVT and sham intervention were not meaningful either. However, the difference between thickness changes by 4 months (52+/-50 microm increase after sham vs. 262+/-115 microm reduction after IVT) was significant (P=0.014).
CONCLUSIONS:
Concerning macular thickness, IVT has beneficial effect on refractory diabetic macular edema as opposed to observation. However, considering visual acuity, it does not induce significant difference in comparison to the natural course of the disease.
AuthorsAlireza Ramezani, Homa Tabatabaie, Hamid Ahmadieh
JournalKorean journal of ophthalmology : KJO (Korean J Ophthalmol) Vol. 21 Issue 2 Pg. 95-9 (Jun 2007) ISSN: 1011-8942 [Print] Korea (South)
PMID17592240 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Glucocorticoids
  • Triamcinolone Acetonide
Topics
  • Diabetic Retinopathy (complications, pathology)
  • Female
  • Follow-Up Studies
  • Glucocorticoids (administration & dosage)
  • Humans
  • Injections
  • Macula Lutea (drug effects, pathology)
  • Macular Edema (drug therapy, etiology, pathology)
  • Male
  • Middle Aged
  • Prospective Studies
  • Time Factors
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Triamcinolone Acetonide (administration & dosage)
  • Visual Acuity
  • Vitreous Body

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