Laser photocoagulation versus combined laser photocoagulation and posterior sub-Tenon's triamcinolone injection for the primary treatment of diffuse diabetic macular edema.
OBJECTIVE
To evaluate the effectiveness of combined treatment with posterior sub-Tenon's triamcinolone injection and focal laser photocoagulation, compared with laser treatment alone, in diffuse diabetic macular edema.


METHODS
This was a nonrandomized, prospective, controlled study that involved 20 eyes with diffuse diabetic macular edema. The patients were divided into 2 groups: group I (10 eyes) received focal laser photocoagulation alone; and group II (10 eyes) received combined focal laser photocoagulation and posterior sub-Tenon's triamcinolone injection. All patients were followed for 6 months. Main outcome measures were final visual outcome and fluorescein leakage and retreatment rates at the end of the follow-up period.


RESULTS
Combined therapy showed better visual and angiographic outcome at 6 months. The retreatment rate was significantly lower in the combined-therapy group compared with the laser-therapy-alone group, with more stable visual acuity.


CONCLUSIONS
Improvement of visual acuity and decreased fluorescein leakage suggest that combination therapy with posterior sub-Tenon's triamcinolone injection and focal laser photocoagulation, particularly when used as a first-line therapy, is advantageous and merits further investigation.
Rahman Mahdy
Reda Abdel
RA
Ophthalmology Department, Zagazig University, Egypt. redaelmahdy2005@yahoo.com <redaelmahdy2005@yahoo.com>
Saleh
Mahmoud M
MM
Almasalamy
Salah M
SM
D000368:Aged; D000792:Angiography; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002908:Chronic Disease; D003131:Combined Modality Therapy; D048909:Diabetes Complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D007834:Lasers; D008028:Light Coagulation; D008266:Macula Lutea / Q000473:pathology; D008269:Macular Edema / Q000188:drug therapy* / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014221:Triamcinolone / Q000008:administration & dosage / Q000627:therapeutic use*; D014605:Uveitis / Q000188:drug therapy
D000893:Anti-Inflammatory Agents; D014221:Triamcinolone