Recurrence of diabetic macular edema after intravitreous injection of triamcinolone following vitrectomy.
OBJECTIVE
To evaluate the effects of intravitreous triamcinolone acetonide (TA) after pars plana vitrectomy (PPV) for diabetic macular edema (DME).


METHODS
We studied a prospective interventional case series. TA was injected intravitreously after PPV in 28 eyes (PPV+TA group). Eyes with DME that met the same criteria and had been treated with PPV alone (29 eyes) were used as controls. The best-corrected visual acuity (VA) and foveal thickness determined by optical coherence tomography were followed up for over 12 months in both groups. Chronological changes of VA and foveal thickness between the groups were evaluated.


RESULTS
In the PPV+TA group, VA had improved at 1 month, but worsened after 3 months. Improvement of foveal thickness was found until 3 months, but not after 6 months. In controls, both VA and foveal thickness continued to improve. The VA of the PPV+TA group was significantly better than that of the controls at 1 and 3 months (P = 0.007 and 0.015, respectively). The foveal thickness of the PPV+TA group was significantly less than that of controls at 1 month (P = 0.0004). These differences became insignificant thereafter, and foveal thickness became significantly worse in the PPV+TA group than in the controls at 12 months (P = 0.0002).


CONCLUSIONS
Although adjunctive use of TA after PPV for DME improved VA and foveal thickness, the effect was transient and foveal thickness increased significantly compared with the PPV alone group at 12 months postoperatively.
Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Science, Kagoshima, Japan.
Yuka
Y
Shimonagano
Norihito
N
Doi
Yoshihiro
Y
Noda
Akinori
A
Uemura
Taiji
T
Sakamoto
D003930:Diabetic Retinopathy / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000473:pathology; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D008269:Macular Edema / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*; D014822:Vitreous Body
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide