[Intravitreal triamcinolone combined with grid laser photocoagulation for patients with cystoid macular edema and advanced diabetic retinopathy: pilot study].

Abstract

BACKGROUND:

To determine if primary intravitreal injection of triamcinolone acetonide (TA) plus grid laser photocoagulation (GLP) is effective in treating cystoid diabetic macular edema (DME).

METHODS:

Prospective comparative non-randomized clinical trial. Fourteen eyes (14 patients) diagnosed with cystoid DME were treated with GLP according to the Early Treatment Diabetic Retinopathy Study (ETDRS) guidelines, plus an intravitreal injection of 4 mg of TA. A matched control group (16 eyes [16 patients]) treated with GLP was selected retrospectively from our medical records. Best-corrected visual acuity (BCVA), and quantitative change in optical coherence tomography (OCT) macular thickness were assessed.

RESULTS:

Mean follow up was 14.9 months (12 to 19 months). In 3 (21.4%) eyes BCVA increased > 2 ETDRS lines, in 5 (35.7%) eyes BCVA remained the same, and BCVA decreased >2 ETDRS lines in 6 (42.8%) eyes. Central macular thickness, as measured by OCT, decreased a mean of 106.2 μm (30.2%). The difference with the control group was not statistically significant (P = .2). Four (28.5%) eyes developed an increased in intraocular pressure in our study group.

CONCLUSIONS:

Although all of our patients showed an improvement of cystoid DME by means of OCT and fluorescein angiography, 42.8% (6 eyes) lost 2 or more lines in BCVA with primary intravitreal injection of TA plus GLP. Primary intravitreal injection of TA plus GLP may not be effective for cystoid DME at 12-months.

• Authors: J F Arévalo, C F Fernández, A J Mendoza, R A García, F A Arévalo
• Journal: Archivos de la Sociedad Espanola de Oftalmologia (Arch Soc Esp Oftalmol) Vol. 88 Issue 10 Pg. 373-9 (Oct 2013) ISSN: 1989-7286 [Electronic] Spain
• Vernacular Title: Triamcinolona intravítrea combinada con fotocoagulación láser en rejilla en pacientes con edema macular quístico y retinopatía diabética avanzada: estudio piloto.
• PMID: 24060300 (Publication Type: Controlled Clinical Trial, English Abstract, Journal Article)
• Copyright: Copyright © 2010 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

Chemical References

• Triamcinolone Acetonide

Topics

• Aged
• Combined Modality Therapy
• Diabetic Retinopathy (drug therapy, surgery, therapy)
• Humans
• Intravitreal Injections
• Laser Coagulation (adverse effects)
• Macular Edema (drug therapy, surgery, therapy)
• Middle Aged
• Ocular Hypertension (chemically induced)
• Pilot Projects
• Prospective Studies
• Treatment Outcome
• Triamcinolone Acetonide (administration & dosage, adverse effects, therapeutic use)
• Visual Acuity