title: Intravitreal triamcinolone compared with macular laser grid photocoagulation for the treatment of cystoid macular edema.
abstract: OBJECTIVE
  To evaluate the outcome of cystoid macular edema (CME) treated with intravitreal injections of triamcinolone acetonide (TA), macular laser grid photocoagulation (MLG), or both (TA+MLG).
  
  
  METHODS
  Prospective, randomized, interventional, parallel, three-arm clinical trial.
  
  
  METHODS
  
  
  
  METHODS
  Institutional clinical study.
  
  
  METHODS
  Fifty-six patients (63 eyes) affected by diabetic or retinal vein occlusion CME.
  
  
  METHODS
  Twenty-two eyes received intravitreal injections of 4 mg TA; 21 eyes underwent MLG; and 20 eyes received intravitreal injection of 4 mg TA, and after 3 months, MLG.
  
  
  METHODS
  Best-corrected visual acuity (VA), central macular thickness (CMT) (by optical coherence tomography), and postoperative complications.
  
  
  RESULTS
  Mean follow-up was 9 +/- 2 months (range 6 to 12 months). Baseline VA (logarithm of minimal angle of resolution [logMAR]) and CMT were, respectively, 0.82 +/- 0.19 and 556 +/- 139 microm microns for the TA group, 0.84 +/- 0.15 and 601 +/- 102 microm microns for the MLG group, and 0.83 +/- 0.22 and 573 +/- 106 microm microns for the TA+MLG group (no statistically significant difference among the groups). After the treatment, at 45 days, 3, 6, and 9 months in the TA group, VA had improved (P = .004) by 0.26, 0.25, 0.22, and 0.23 logMAR and CMT had decreased by 37%, 33%, 29%, and 31% (P = < .001). In the MLG group, VA was unchanged although CMT had decreased by 5%, 13%, 14%, and 16% (P = .021). In the TA+MLG group, VA had improved (P = .003) by 0.26, 0.24, 0.19, and 0.20 logMAR, and CMT had decreased by 36%, 34%, 28%, and 29% (P = < .001). The groups receiving triamcinolone had better VA and lower CMT values at all time points (P < .05). A reinjection was performed in eight eyes; intraocular pressure increased in nine eyes (treated with medical therapy), and cataract progressed in one eye. No injection-related complications occurred.
  
  
  CONCLUSIONS
  TA intravitreal injection improves VA and reduces CMT more than MLG, which in triamcinolone-treated eyes does not offer further advantages. Intravitreal TA injection could be used as primary treatment in patients with CME.
authors.affiliation: Sezione di Oftalmologia, Dipartimento di Specialità Medico-Chirurgiche, Università di Catania, Catania, Italy. Clinica.Oculistica@mbox.unict.it
authors.forename: Teresio
authors.initials: T
authors.lastname: Avitabile
authors.forename: Antonio
authors.initials: A
authors.lastname: Longo
authors.forename: Alfredo
authors.initials: A
authors.lastname: Reibaldi
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D003930:Diabetic Retinopathy / Q000150:complications; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D017075:Laser Coagulation; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012160:Retina / Q000187:drug effects / Q000473:pathology; D015356:Retinal Artery Occlusion / Q000150:complications; D012170:Retinal Vein Occlusion / Q000150:complications; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014792:Visual Acuity; D014822:Vitreous Body
chemical_list: D005938:Glucocorticoids; D014222:Triamcinolone Acetonide