Pretreatment of posterior subtenon injection of triamcinolone acetonide has beneficial effects for grid pattern photocoagulation against diffuse diabetic macular oedema.
OBJECTIVE
To prospectively evaluate the efficacy of subtenon injection of triamcinolone acetonide (TA) before laser grid pattern photocoagulation (G-PC) for the treatment of diffuse diabetic macular oedema (DDME).


METHODS
42 eyes of 37 consecutive patients with DDME were studied. 1 week before G-PC, 21 eyes received TA subtenon injection, and the other eyes served as control. The clinical course of visual acuity (VA) and foveal thickness (FT) was monitored for up to 24 weeks after G-PC. Mean deviation (MD) of perimetry with 30-2 program on Humphrey Perimeter (Zeiss-Humphrey, Dublin, California, USA) was also measured. The average laser intensity was recorded.


RESULTS
After TA injection, FT and VA were improved, and subsequent G-PC maintained the improvement for up to 24 weeks without recurrence of diffuse diabetic macular oedema. In contrast, G-PC without TA injection induced transient worsening of FT and VA, then both were gradually improved. At 24 weeks after G-PC, MD in the TA-injected eyes was better than those in control. The required laser intensity in TA-injected eyes was less than that for control.


CONCLUSIONS
Subtenon injection of TA prior to G-PC allows for treatment with a lower intensity of laser spots and also prevents the decrease in central visual field sensitivity, all of which have clinical advantages for G-PC.
Shimura
Masahiko
M
Department of Ophthalmology, NTT East Japan Tohoku Hospital, 2-29-1, Yamato, Wakabayashi, Sendai, Miyagi 984-8560, Japan. masahiko@v101.vaio.ne.jp
Nakazawa
Toru
T
Yasuda
Kanako
K
Shiono
Takashi
T
Nishida
Kohji
K
D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005584:Fovea Centralis / Q000473:pathology; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007267:Injections; D017075:Laser Coagulation; D008269:Macular Edema / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000627:therapeutic use*; D014792:Visual Acuity / Q000187:drug effects; D058609:Visual Field Tests / Q000379:methods
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide