[Macular thickness analysis by optic coherence tomography in refractory diabetic macular edema treated with intravitreous triamcinolone].
OBJECTIVE
To assess the effect of intravitreal injections of triamcinolone on macular thickness (Stratus-OCT), intra-ocular pressure and visual acuity, in the treatment of diabetic macular edema non-responsive to previous laser photocoagulation, over a 6-month period.


METHODS
The study included 21 subjects (22 eyes) who underwent complete ophthalmologic examination, measurements of visual acuity and intraocular pressure, and OCT, previously treated with at least 2 laser applications. The study participants were treated with 4 mg/0.1 ml intravitreal triamcinolone. Follow-up visits were scheduled for the 1st day after treatment, and after 1, 3 and 6 months. Visual and anatomical results, as well as possible complications associated with the intravitreal injection procedure were studied.


RESULTS
The study showed a significant reduction in mean macular thickness, assessed by OCT at 1, 3 and 6 months post-treatment (p=0.001), combined with an improvement of the mean visual acuity (p<0.001). Central macular thickness mean+/-SD value on the first visit was 399 (+/-121 microm); it was reduced by 39.9% (239+/-53 microm) at the first month (p<0.001), 35.5% (255+/-93 microm) at the third month (p<0.001), and 18.1% (326+/-135 microm) at the sixth month (p=0.001). The improvement in mean visual acuity was of 18 and 16 letters on the ETDRS table, on the 3rd and 6th month, respectively. Reported complications were an increase in intraocular pressure in seven eyes (33.3% of the cases).


CONCLUSIONS
A reduction in mean retinal thickness was observed throughout the entire follow-up period, with significant increase in macular thickness between the 3rd and 6th month. The mean visual acuity showed statistically significant improvement at the end of the follow-up period, but no change was noticed between the 3rd and 6th month.
D000368:Aged; D000704:Analysis of Variance; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / 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; D011446:Prospective Studies; D012160:Retina / Q000473:pathology*; D013997:Time Factors; D041623:Tomography, Optical Coherence; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000627:therapeutic use*; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body
D005938:Glucocorticoids; D014222:Triamcinolone Acetonide
Análise da espessura macular pela tomografia de coerência óptica no edema macular refratário de origem diabética após aplicação de triancinolona intravítrea.