Korean J Ophthalmol.  2009 Sep;23(3):153-158. 10.3341/kjo.2009.23.3.153.

Comparison of Photocoagulation With Combined Intravitreal Triamcinolone for Diabetic Macular Edema

• Lee HY
• Lee SY
• Park JS

• KMID: 1115745
• DOI: http://doi.org/10.3341/kjo.2009.23.3.153

Abstract

PURPOSE
To compare the efficacy between macular laser grid (MLG) photocoagulation and MLG plus intravitreal triamcinolone acetonide (IVTA; MLG+IVTA) therapy in diabetic macular edema (DME) patients. METHODS: A prospective, randomized, clinical trial was conducted of DME patients. A total of 60 eyes (54 patients) affected by DME were observed for a minimum of 6 months. Thirty eyes of 28 patients who received MLG treatment and 30 eyes of 26 patients who received the combined MLG+IVTA treatment were included in the study. Main outcome measures were BCVA and central macular thickness (CMT) as measured by optical coherence tomography (OCT) at 1, 3, and 6 months after treatment. Additionally, the authors examined retrospectively 20 eyes of 20 patients who were treated with only IVTA and compared with the 2 groups (MLG group and MLG+IVTA group). RESULTS: Baseline BCVA was 0.53+/-0.32 and CMT was 513.9+/-55.1 microm in the MLG group. At 1 and 3 months after treatment, the MLG group showed no significant improvement of BCVA and CMT, although there was significant improvement after 6 months. In the MLG+IVTA group, the baseline BCVA was 0.59+/-0.29 and CMT was 498.2+/-19.8 microm. After treatment, significant improvement of BCVA and CMT was observed at all follow-up time periods. When comparing the MLG group with the MLG+IVTA group, the latter had better results after 1 and 3 months, although at 6 months, there was no significant difference of BCVA and CMT between the 2 groups. Additionally, the IVTA group showed more improvement than the MLG group at 1 and 3 months but showed no significant difference at 6 months. In addition, the IVTA group showed no significant difference with the MLG+IVTA group at all follow-up time periods. CONCLUSIONS: For DME patients, the combined MLG+IVTA treatment had a better therapeutic effect than the MLG treatment for improving BCVA and CMT at the early follow-up time periods. IVTA treatment alone could be an additional alternative therapeutic option to combined therapy.

Keyword

Central macular thickness; Diabetic macular edema; Diabetic retinopathy; Intravitreal triamcinolone acetonide injection; Macular laser grid photocoagulation

MeSH Terms

Aged
Diabetic Retinopathy/*drug therapy/pathology/physiopathology/*surgery
Follow-Up Studies
Glucocorticoids/*administration & dosage
Humans
Injections
*Laser Coagulation
Macular Edema/*drug therapy/pathology/physiopathology/*surgery
Middle Aged
Postoperative Period
Tomography, Optical Coherence
Triamcinolone Acetonide/*administration & dosage
Visual Acuity
Vitreous Body

Figure

• 

  Fig. 1 Graph illustrating BCVA(logMAR) in eyes affected with DME. In the MLG+IVTA and IVTA groups, compared with baseline, values were significantly lower at all time points (Wilcoxon signed ranks test). Compared with the MLG group, values for MLG+IVTA and IVTA groups were significantly lower at 1 and 3 months but had no difference 6 months after treatment. No difference was observed between the MLG+IVTA and IVTA groups (one-way ANOVA test).

• 

  Fig. 2 Graph illustrating central macular thickness (CMT) in eyes-affected with DME. In the MLG+IVTA and IVTA groups, compared with baseline, values were significantly lower at all time points (Wilcoxon signed ranks test). Compared with the MLG, values for the MLG+IVTA and IVTA groups were significantly lower at 1 and 3 months but had no difference 6 months after treatment. No deference was observed between the MLG+IVTA and IVTA groups (oneway ANOVA test).

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