title: [Use of intravitreal triamcinolone and laser photocoagulation for the treatment of diffuse diabetic macular edema].
abstract: OBJECTIVE
  To assess the efficacy of intravitreal use of triamcinolone acetonide combined with laser photocoagulation for the treatment of diffuse diabetic macular edema and to compare it with the separate use of each treatment.
  
  
  METHODS
  After systemic clinical control, thirty patients with diffuse diabetic macular edema were divided into 3 treatment groups: (1) macular grid photocoagulation; (2) intravitreal injection of 4 mg of triamcinolone acetonide; (3) combination of the two previous therapies. Follow-up was scheduled at predetermined intervals of one day, one week and monthly until completion of six months. The following parameters were analyzed: LogMAR best corrected visual acuity, central macular thickness, total macular volume and intraocular pressure.
  
  
  RESULTS
  Grid photocoagulation did not significantly reduce the central macular thickness or the total macular volume. On the other hand, this reduction was statistically significant in the other two groups. All groups improved their mean visual acuity, however, the group that received both treatments had a higher percentage of patients that gained 10 or more letters.
  
  
  CONCLUSIONS
  The simultaneous administration of grid photocoagulation with intravitreal triamcinolone can be considered an option for the treatment of diffuse diabetic macular edema.
authors.affiliation: Departamento de Oftalmologia e Otorrinolaringologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil. fabiopetersen@yahoo.com.br
authors.forename: Fábio Petersen
authors.initials: FP
authors.lastname: Saraiva
authors.forename: Márcia Silva
authors.initials: MS
authors.lastname: Queiroz
authors.forename: Patricia Grativol
authors.initials: PG
authors.lastname: Costa
authors.forename: Fábio
authors.initials: F
authors.lastname: Gasparin
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Nakashima
mesh_terms: D003131:Combined Modality Therapy / Q000379:methods; D003627:Data Interpretation, Statistical; D003930:Diabetic Retinopathy / Q000188:drug therapy / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007267:Injections; D007429:Intraocular Pressure / Q000187:drug effects / Q000502:physiology; D017075:Laser Coagulation; D008269:Macular Edema / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000627:therapeutic use*; D014792:Visual Acuity / Q000187:drug effects / Q000502:physiology; D014822:Vitreous Body
chemical_list: D005938:Glucocorticoids; D014222:Triamcinolone Acetonide