title: Three-year follow-up of a randomized trial comparing focal/grid photocoagulation and intravitreal triamcinolone for diabetic macular edema.
abstract: OBJECTIVE
  To report 3-year outcomes of patients who participated in a randomized trial evaluating 1-mg and 4-mg doses of preservative-free intravitreal triamcinolone compared with focal/grid photocoagulation for treatment of diabetic macular edema.
  
  
  METHODS
  Eyes with diabetic macular edema and visual acuities of 20/40 to 20/320 were randomly assigned to focal/grid photocoagulation or 1 mg or 4 mg of triamcinolone. At the conclusion of the trial, 3-year follow-up data were available in 306 eyes.
  
  
  RESULTS
  Between 2 years (time of the primary outcome) and 3 years, more eyes improved than worsened in all 3 treatment groups. Change in visual acuity letter score from baseline to 3 years was +5 in the laser group and 0 in each triamcinolone group. The cumulative probability of cataract surgery by 3 years was 31%, 46%, and 83% in the laser and 1-mg and 4-mg triamcinolone groups, respectively. Intraocular pressure increased by more than 10 mm Hg at any visit in 4%, 18%, and 33% of eyes, respectively.
  
  
  CONCLUSIONS
  Results in a subset of randomized subjects who completed the 3-year follow-up are consistent with previously published 2-year results and do not indicate a long-term benefit of intravitreal triamcinolone relative to focal/grid photocoagulation in patients with diabetic macular edema similar to those studied in this clinical trial. Most eyes receiving 4 mg of triamcinolone as given in this study are likely to require cataract surgery.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT00367133.
authors.forename: Roy W
authors.initials: RW
authors.lastname: Beck
authors.forename: Allison R
authors.initials: AR
authors.lastname: Edwards
authors.forename: Lloyd P
authors.initials: LP
authors.lastname: Aiello
authors.forename: Neil M
authors.initials: NM
authors.lastname: Bressler
authors.forename: Frederick
authors.initials: F
authors.lastname: Ferris
authors.forename: Adam R
authors.initials: AR
authors.lastname: Glassman
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hartnett
authors.forename: Michael S
authors.initials: MS
authors.lastname: Ip
authors.forename: Judy E
authors.initials: JE
authors.lastname: Kim
authors.forename: Craig
authors.initials: C
authors.lastname: Kollman
mesh_terms: D000368:Aged; D002386:Cataract / Q000139:chemically induced; D002387:Cataract Extraction / Q000706:statistics & numerical data; D003930:Diabetic Retinopathy / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007267:Injections; D007429:Intraocular Pressure; D017075:Laser Coagulation / Q000379:methods*; D008269:Macular Edema / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011310:Preservatives, Pharmaceutical; D012160:Retina / Q000187:drug effects / Q000473:pathology; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000009:adverse effects / Q000627:therapeutic use*; D014792:Visual Acuity; D014822:Vitreous Body
chemical_list: D005938:Glucocorticoids; D011310:Preservatives, Pharmaceutical; D014222:Triamcinolone Acetonide