title: Efficacy and safety of multiple intravitreal triamcinolone injections for refractory diabetic macular oedema.
abstract: OBJECTIVE
  The efficacy and safety of repeated injections of intravitreal triamcinolone (IVTA) for diabetic macular oedema is unclear, with results of previous reports conflicting.
  
  
  METHODS
  This is a prospective, observational case series of 27 eyes receiving IVTA for diabetic macular oedema. LogMAR visual acuity (VA) and central macular thickness (CMT) were measured at baseline and in 3 to 6 monthly intervals for up to 24 months, then correlated with the number of IVTA injections given.
  
  
  RESULTS
  One IVTA injection was required in 6 (18%) eyes, 2 in 8 (24%) eyes, 3 in 13 (39%) eyes and 4-5 in 6 (18%) eyes. VA improved in all patients, but neither the final improvement in VA nor the absolute improvement in CMT from baseline to 24 months correlated with the number of injections received (p = 0.44 and 0.84, respectively). Cataract surgery was more frequent in eyes receiving more injections (p = 0.01).
  
  
  CONCLUSIONS
  This study suggests that repeated injections of IVTA continue to be as effective as the first over a 2-year period. The probability of cataract surgery increases with an increasing number of injections.
authors.affiliation: Save Sight and Eye Health Institute, Department of Clinical Ophthalmology, University of Sydney, GPO Box 4337, Sydney NSW 2001, Australia. mark@eye.usyd.edu.au
authors.forename: Mark C
authors.initials: MC
authors.lastname: Gillies
authors.forename: F M Amirul
authors.initials: FM
authors.lastname: Islam
authors.forename: Meidong
authors.initials: M
authors.lastname: Zhu
authors.forename: Jorgen
authors.initials: J
authors.lastname: Larsson
authors.forename: Tien Y
authors.initials: TY
authors.lastname: Wong
mesh_terms: D000368:Aged; D002387:Cataract Extraction; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D004334:Drug Administration Schedule; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007267:Injections; D008266:Macula Lutea / Q000473:pathology; D008269:Macular Edema / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014221:Triamcinolone / Q000008:administration & dosage* / Q000009:adverse effects; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body
chemical_list: D005938:Glucocorticoids; D014221:Triamcinolone