title: Diabetic macular edema before and after intravitreal triamcinolone injection.
abstract: OBJECTIVE
  To compare intravitreal triamcinolone acetonide (IVT) versus natural course in refractory diabetic macular edema.
  
  
  METHODS
  In a prospective interventional case series, twenty five eyes with refractory DME which had been allocated to the sham group of a previous clinical trial underwent new examination and optical coherence tomography about 9 months after their first enrollment. Twenty eyes that met the inclusion criteria, visual acuity (VA) < 20/50 and central macular thickness (CMT) > 200 microm, were treated by 4 mg IVT. Evaluations were repeated at 2 and 4 months post-injection to imitate the similar examination intervals after sham injection. Corrected visual acuity and macular thickness changes following IVT were compared to the corresponding changes after sham injection (the natural course).
  
  
  RESULTS
  Visual acuity changes within and between each period were not statistically significant. Visual acuity decreased 0.08 & 0.09 logMAR by 2 months and 0.06 & 0.04 logMAR by 4 months after sham and IVT injections, respectively. The changes of macular thickness after IVT and sham intervention were not meaningful either. However, the difference between thickness changes by 4 months (52+/-50 microm increase after sham vs. 262+/-115 microm reduction after IVT) was significant (P=0.014).
  
  
  CONCLUSIONS
  Concerning macular thickness, IVT has beneficial effect on refractory diabetic macular edema as opposed to observation. However, considering visual acuity, it does not induce significant difference in comparison to the natural course of the disease.
authors.affiliation: Ophthalmic Research Center, Shaheed Beheshti Medical University, Tehran, Iran. arramezani@gmail.com
authors.forename: Alireza
authors.initials: A
authors.lastname: Ramezani
authors.forename: Homa
authors.initials: H
authors.lastname: Tabatabaie
authors.forename: Hamid
authors.initials: H
authors.lastname: Ahmadieh
mesh_terms: D003930:Diabetic Retinopathy / Q000150:complications* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D008266:Macula Lutea / Q000187:drug effects / Q000473:pathology*; D008269:Macular Edema / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014792:Visual Acuity; D014822:Vitreous Body
chemical_list: D005938:Glucocorticoids; D014222:Triamcinolone Acetonide