Intravitreal triamcinolone injection for diffuse diabetic macular edema with foveal cystoid changes.
BACKGROUND
Diabetic macular edema causes visual loss in almost one-third of diabetic patients. There is currently no treatment for the accompanying cystoid foveal changes.


OBJECTIVE
To assess the clinical outcome, i.e., change in visual acuity, in patients treated with steroids for long-standing diabetic macular edema with foveal cystoid changes.


METHODS
In the ophthalmology department of a tertiary care university-affiliated medical center and the ophthalmology service of a health management organization, 46 diabetic subjects (56 eyes) who had diabetic macular edema with cystoid foveal changes received one intravitreal injection of 4 mg triamcinolone acetonide.


RESULTS
The mean baseline (pre-injection) visual acuity of 0.21 increased to 0.31 and 0.48 at 1 and 3 months, respectively, after which it decreased to 0.33 at 6 months. The mean intraocular pressure was 15.07 mmHg at baseline, 15.83 at day 1, gradually rising to 17.16, 18.38 and 18.57 mmHg at 1, 3 and 6 months respectively. Three patients suffered immediate visual decline after the injection.


CONCLUSIONS
Intravitreal triamcinolone acetonide may be a therapeutic option for long-standing diabetic macular edema with foveal cystoid changes.
Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. omadb@post.tau.ac.il
Adiel
A
Barak
Michael
M
Regenbogen
Michaella
M
Goldstein
Anat
A
Loewenstein
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D003930:Diabetic Retinopathy / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005584:Fovea Centralis / Q000187:drug effects / Q000503:physiopathology; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007267:Injections; D008269:Macular Edema / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage* / Q000627:therapeutic use; D014792:Visual Acuity; D014822:Vitreous Body
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D014222:Triamcinolone Acetonide