Korean J Ophthalmol.  2009 Jun;23(2):80-85. 10.3341/kjo.2009.23.2.80.

Dose Dependent Effects of Intravitreal Triamcinolone Acetonide on Diffuse Diabetic Macular Edema

• Bae JS
• Park SJ
• Ham IR
• Lee TG

• KMID: 754722
• DOI: http://doi.org/10.3341/kjo.2009.23.2.80

Abstract

PURPOSE: To evaluate the effect of different doses of intravitreal triamcinolone acetonide on diffuse diabetic macular edema.
METHODS
In a retrospective study, 44 eyes with diffuse diabetic macular edema were treated with an intravitreal injection of 4 mg (n=12 eyes), 8 mg (n=17) or 25 mg (n=15) of triamcinolone acetonide (TA). Optical coherence tomography, best-corrected logMAR visual acuity and Goldmann tonometry were performed at baseline, 1 week, and 1, 3, 6, 9 and 12 months after treatment. Mean follow-up was 9.8 months (standard deviation=2.3) with a range of 5-12 months.
RESULTS
The duration of intravitreal TA effects on macular thickness and visual acuity increased with increasing dosage. An observed increase in intraocular pressure induced by TA was not significantly associated with dosage.
CONCLUSIONS
In patients with diffuse diabetic macular edema who receive intravitreal TA, effects may last longer after a dosage of 25 mg, than after lower doses of 8 mg or 4 mg.

Keyword

Diabetic macular edema; Intravitreal triamcinolone acetonide injection

MeSH Terms

Adult
Aged
Aged, 80 and over
Diabetic Retinopathy/*complications/drug therapy/pathology
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Glucocorticoids/*administration & dosage
Humans
Injections
Intraocular Pressure
Macular Edema/diagnosis/*drug therapy/etiology
Male
Middle Aged
Retrospective Studies
Time Factors
Tomography, Optical Coherence
Treatment Outcome
Triamcinolone Acetonide/*administration & dosage
Visual Acuity
Vitreous Body

Figure

• 

  Fig. 1 Time course of macular thicknesses using OCT 3. Among the three groups, significant differences in macular thickness were seen at 6, 9 and 12 months (p=0.036, 0.028, 0.008 by ANOVA). In post-hoc tests, macular thickness in the 25 mg group was significantly thinner than in the 4 mg group at 6 months, and the other two groups at 9 and 12 months (p<0.05 by Tukey).

• 

  Fig. 2 Time course of logMAR visual acuities. Significant differences among the three groups were seen at the 9- and 12-month follow-up (p<0.05 by ANOVA). The 25 mg study group showed significantly better visual acuity than other two groups (p<0.05) by a post-hoc test.

• 

  Fig. 3 Time course of intraocular pressure. At 6, 9, and 12 months, significantly different results were obtained among the three groups (p=0.027, 0.025, 0.028 by ANOVA). Group 1 and 2 showed significant differences (p=0.025, 0.027) at 6 and 12 months, and groups 1 and 3 showed differences (p=0.025) at 9-months by posthoc test.

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