Intravitreal triamcinolone as an adjunct in the treatment of concomitant proliferative diabetic retinopathy and diffuse diabetic macular oedema. Combined IVTA and laser treatment for PDR with CSMO.
OBJECTIVE
To investigate if triamcinolone acetonide (TA) can be an adjunct to laser treatment in patients with concomitant non-high-risk proliferative diabetic retinopathy (PDR) and diffuse clinically significant diabetic macular oedema (CSMO).


METHODS
This prospective, interventional and comparative clinical study included 32 eyes of 16 patients with bilateral concomitant non-high-risk PDR and diffuse CSMO. Each patient received 4 mg intravitreal TA for the eye with worse visual acuity (study group) and macular focal and grid laser photocoagulation (MP) for the other eye (control group). One month later, each patient received four sessions of panretinal photocoagulation for both eyes plus MP for the eyes in the study group. The visual and angiographic results of both groups were compared.


RESULTS
In the study group, the mean visual acuity (VA) improved from 0.12 +/- 2.3 lines at the baseline to 0.19 +/- 3.1 (P = 0.004), 0.20 +/- 3.2 (P = 0.004), 0.19 +/- 3.6 (P = 0.009) and 0.19 +/- 3.3 lines (P = 0.091) at the 1-, 3-, 6- and 9-month follow-up intervals, respectively. The macular oedema was found to be resolved in 11 eyes (69%) and decreased in five eyes (31%). In the control group, the mean VA deteriorated progressively from 0.41 +/- 3.1 lines at the baseline to 0.20 +/- 3.1 lines (P = 0.026) at the end of the study and the macular oedema decreased only in three eyes (19%) at the sixth follow-up month.


CONCLUSIONS
During the follow-up period of the study, intravitreal TA as an adjunct in the treatment of concomitant non-high-risk PDR and diffuse CSMO led to a more-favourable clinical outcome than conventional laser treatment.
Kaderli
Berkant
B
Department of Ophthalmology, Uludag University Hospital, 16059 Gorukle, Bursa, Turkey.
Avci
Remzi
R
Gelisken
Oner
O
Yucel
Ahmet Ali
AA
D000328:Adult; D000368:Aged; D003930:Diabetic Retinopathy / Q000150:complications / Q000473:pathology / Q000628:therapy*; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D017075:Laser Coagulation / Q000379:methods*; D008269:Macular Edema / Q000150:complications / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014792:Visual Acuity; D014822:Vitreous Body
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide