Trans-Tenon's retrobulbar injection of triamcinolone acetonide for diffuse diabetic macular edema.
OBJECTIVE
To determine whether a trans-Tenon's retrobulbar injection of triamcinolone acetonide (TA) is a safe and effective treatment for diffuse diabetic macular edema.


METHODS
Thirty-nine eyes of 30 diabetic patients with persistent macular edema were treated with 20 mg of TA injection. Central macular thickness (CMT) determined by optical coherence tomography (OCT) and visual acuity were evaluated before the injection and at 1, 2, 3, and 6 months, and up to 1 year in some eyes, after the injection.


RESULTS
The CMT decreased significantly from 478 +/- 129 microm (mean +/- SD) before injection to 316 +/- 102 microm at 1 month, 307 +/- 104 microm at 2 months, and 275 +/- 89 microm at 3 months after a single injection of TA. A 20% reduction of CMT from the initial value was maintained by a single injection of TA in 27 of 39 eyes (69.2%) at 3 months, in 14 of 22 eyes (63.6%) at 6 months, and in 5 of 7 eyes at 12 months. A recurrence of macular edema was observed in 10% of the eyes at 3 months, and in 22.7% at 6 months. The 17 eyes in which vitrectomy had been carried out had a more significant improvement in CMT than the eyes without vitrectomy.


CONCLUSIONS
A 20-mg trans-Tenon's retrobulbar TA injection is a safe and effective treatment for diabetic macular edema.
Wada
Mitsumasa
M
Department of Ophthalmology, Kansai Medical University, Moriguchi, Japan.
Ogata
Nahoko
N
Department of Ophthalmology, Kansai Medical University, Moriguchi, Japan. ogata@takii.kmu.ac.jp.
Minamino
Keizo
K
Department of Ophthalmology, Kansai Medical University, Moriguchi, Japan.
Koriyama
Masataka
M
Department of Ophthalmology, Kansai Medical University, Moriguchi, Japan.
Higuchi
Akiko
A
Department of Ophthalmology, Kansai Medical University, Moriguchi, Japan.
Matsumura
Miyo
M
Department of Ophthalmology, Kansai Medical University, Moriguchi, Japan.
D000368:Aged; D003930:Diabetic Retinopathy / Q000150:complications* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D008269:Macular Edema / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009915:Orbit; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014792:Visual Acuity
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide