[Intravitreal triamcinolone acetonide for diffuse diabetic macular edema--one year follow-up].
BACKGROUND
Macular edema is the main cause of visual impairment in diabetic patients. Its treatment is mainly based on laser photocoagulation. Intravitreal triamcinolone acetonide (TA) has recently been proposed as a new treatment for eyes with diabetic macular edema resistant to conventional laser photocoagulation.


OBJECTIVE
To evaluate the one year efficacy and safety of a single TA injection administered for diffuse diabetic macular edema unresponsive to prior laser treatment.


METHODS
Interventional case series.


METHODS
Setup: University medical center out-patient clinic.


METHODS
Twenty-one patients with bilateral diffuse diabetic macular edema.


METHODS
A single intravitreal injection of triamcinolone acetonide.


METHODS
Visual acuity measured by ETDRS score, retinal area evaluation clinically and retinal thickness evaluation by Retinal Thickness Analysis (RTA) at 3 and 12 months following injection. Secondary outcomes were intraocular pressure control and cataract progression.


RESULTS
Three months following injection, the mean improvement in visual acuity was 4.7 +/- 11.7 letters in the study group as compared to 0.2 +/- 11.4 in the control group (p = 0.18). No difference was noticed one year following injection. Clinical assessment of the retinal area of edema revealed a substantial difference between patients and controls at 3 months (p = 0.0006) and at one year (p = 0.05). RTA evaluation revealed improvement in retinal thickness solely at the 3 months exam. Four eyes developed high intraocular pressure and required treatment (p = 0.054). No difference in cataract progression was noted between the two groups (p = 0.69).


CONCLUSIONS
Injection of TA may improve visual acuity for a limited time. Increased intraocular pressure is a frequent side effect. During a one year follow-up, no evidence of ocular toxicity was noted in eyes with diffuse diabetic macular edema.
Thein
Ran
R
Eye Deparment, Kaplan Medical Center, Rehovot, Israel.
Pollack
Ayala
A
Bukelman
Amir
A
Katz
Haya
H
Pokroy
Reuven
R
Len
Ariela
A
Parnes
Rehut
R
Aloni
Eyal
E
Hauser
David
D
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008269:Macular Edema / Q000188:drug therapy*; D012160:Retina / Q000187:drug effects; D014222:Triamcinolone Acetonide / Q000009:adverse effects / Q000627:therapeutic use*; D014792:Visual Acuity; D014822:Vitreous Body
D000893:Anti-Inflammatory Agents; D014222:Triamcinolone Acetonide