Follow-up after intravitreal triamcinolone acetonide for diabetic macular edema.
OBJECTIVE
To report on the follow-up of patients who received an intravitreal high-dosage injection of triamcinolone acetonide (IVTA) as treatment of diffuse diabetic macular edema.


METHODS
The clinical interventional case-series study included 109 eyes (90 patients) with diffuse diabetic macular edema who consecutively received an IVTA of about 20 mg. Mean follow-up was 11.2 +/- 6.2 months.


RESULTS
Visual acuity improved significantly (p<0.001) from 0.89 +/- 0.33 logMAR to a best minimum of 0.65 +/- 0.35 logMAR. An increase in best visual acuity by at least 1 Snellen line, 2 lines, and 3 lines was found in 91 (83%) eyes, 68 (62%) eyes, and 45 (41%) eyes, respectively. Differences in visual acuity between baseline and follow-up examinations were significant for measurements performed at 1 month (p<0.001), 2 months (p<0.001), 3 months (p<0.001), and at 6 months (p=0.001) after the injection. At 9 months after the injection, mean visual acuity regressed significantly so that visual acuity at 9 months (p=0.83) and at 12 months after the injection (p=0.58) compared with baseline values did not differ significantly. Forty-seven (43%) eyes developed a rise in intraocular pressure (pressure >21 mmHg) for 6 to 8 months after the injection. No other severe complications were detected.


CONCLUSIONS
The duration of a visual acuity increase and intraocular pressure rise after high-dosage IVTA in diffuse diabetic macular edema is about 6 to 8 months. Compared with data in the literature, the high-dosage IVTA may not have a markedly higher profile of side effects than low-dosage IVTA.
Jonas
J B
JB
Department of Ophthalmology, Faculty of Clinical Medicine Mannheim, Universitäts-Augenklinik, Ruprecht-Karls-University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. Jost.Jonas@augen.ma.uni-heidelberg.de
Spandau
U H
UH
Kamppeter
B A
BA
Vossmerbaeumer
U
U
Harder
B
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003930:Diabetic Retinopathy / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D007429:Intraocular Pressure / Q000187:drug effects; D008269:Macular Edema / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014792:Visual Acuity / Q000187:drug effects; D014822:Vitreous Body
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide