Korean J Ophthalmol.  2007 Jun;21(2):95-99. 10.3341/kjo.2007.21.2.95.

Diabetic Macular Edema Before and After Intravitreal Triamcinolone Injection

• Ramezani A
• Tabatabaie H
• Ahmadieh H

• KMID: 1101911
• DOI: http://doi.org/10.3341/kjo.2007.21.2.95

Abstract

PURPOSE: 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 micrometer, 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 micrometer increase after sham vs. 262+/-115 micrometer 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.

Keyword

Diabetic macular edema; Intraocular pressure; Intravitreal triamcinolone; Natural course; Macular thickness

MeSH Terms

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

Figure

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  Fig. 1 Mean visual acuity before, 2, 4 and about 8 months after the sham injection.

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  Fig. 2 Mean central macular thickness before, 2, 4 and about 8 months after the sham injection.

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  Fig. 3 Mean central macular thickness changes after sham and IVT injections.

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  Fig. 4 Mean intraocular pressure changes after sham and IVT injections.

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