Pilot study of intravitreal injection of diclofenac for treatment of macular edema of various etiologies.
OBJECTIVE
The purpose of this study was to evaluate the effect of a single dose of intravitreal diclofenac, a potent nonsteroidal antiinflammatory drug, on visual acuity and central macular thickness in patients with macular edema of various etiologies.


METHODS
In this prospective noncomparative case series, 10 eyes of 10 patients with clinically significant diabetic macular edema (n = 5), neovascular age-related macular degeneration (n = 2), pseudophakic cystoid macular edema (n = 1), macular edema secondary to old branch retinal vein occlusion (n = 1), and cystoid macular edema secondary to chronic intermediate uveitis (n = 1) received 500 microg/0.1 mL of intravitreal diclofenac. The primary outcome measure was change in visual acuity.


RESULTS
After 2 weeks, visual acuity improved in 3 (30%) eyes (P = 0.78), did not change in 3 (30%) eyes, and decreased in 3 (30%) eyes. After 4 weeks, improvement of best-corrected visual acuity occurred in 5 (50%) eyes (P = 0.07), but in 3 eyes (30%), best-corrected visual acuity did not change, and in 1 eye (10%), visual acuity decreased. After 8 weeks, visual acuity improved in 7 (70%) eyes (P = 0.019), got worse in 1 eye (10%), and did not change in 2 eyes (20%). Central macular thickness did not decrease significantly at 8 weeks. On the basis of electroretinography, no significant changes in the amplitude of a-wave or b-wave in relation to baseline were noticed in any eye.


CONCLUSIONS
Up to 8 weeks, intravitreal diclofenac treatment of eyes with macular edema of various etiologies yielded prominent improvement in visual acuity but was not associated with a significant decrease in central macular thickness. No toxic effect of intravitreal diclofenac was observed.
Soheilian
Masoud
M
Ophthalmology Department and Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University (MC), Tehran, Iran. masoud_soheilian@yahoo.com
Karimi
Saeed
S
Ramezani
Alireza
A
Peyman
Gholam A
GA
D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000009:adverse effects; D004008:Diclofenac / Q000008:administration & dosage* / Q000009:adverse effects; D004596:Electroretinography; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007267:Injections; D008269:Macular Edema / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012160:Retina / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body
D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac