title: Treatment of diffuse diabetic maculopathy with intravitreal triamcinolone and laser photocoagulation: randomized clinical trial with morphological and functional evaluation.
abstract: OBJECTIVE
  Treatment of diffuse macular edema in diabetes mellitus is currently unsatisfactory. The purpose of this double blind randomized clinical trial was to compare the treatment of diffuse diabetic macular edema with intravitreal triamcinolone or laser in type 2 diabetes mellitus patients using a morphofunctional assessment.
  
  
  METHODS
  Fourteen patients (21 eyes) with clinically significant diffuse macular-edema, previously untreated and with a macular thickness >250 µm at optical coherence tomography were randomized for treatment with laser or intravitreal injection of triamcinolone acetate. Optical coherence tomography, biomicroscopy, fundoscopy, fluorescein angiography, tonometry, scotometry, visual and contrast acuities were performed at 0, 1, 3 and 6 months.
  
  
  RESULTS
  At pre-treatment stage, Laser (n=9) and Triamcinolone (n=12) groups did not differ regarding retinal thickness, visual and contrast acuities. In Triamcinolone group macular thickness decreased after 1 month (424.1 ± 19.9 µm to 358.4 ± 18.2 µm; p=0.04) and started to return to the initial values in the 3(rd) month (p=0.02). No changes occurred in macular scotometry and visual and contrast acuities. No side effects were observed with both treatments.
  
  
  CONCLUSIONS
  During the study macular thickness diminished in the triamcinolone group, especially in the first month of treatment. At 3 and 6 months there was no difference. Macular thickness did not change during the study in the laser group. In the study sample it was not possible to demonstrate differences relates to visual acuity and scotometry between the two groups. CLINICALTRIALS.GOV IDENTIFIER: NCT00668239.
authors.affiliation: Serviço de Oftalmologia, Hospital de Clínicas de Porto Alegre, RS, Brazil. albertogil@brturbo.com.br
authors.forename: Alberto Luiz
authors.initials: AL
authors.lastname: Gil
authors.forename: Mirela Jobim de
authors.initials: MJ
authors.lastname: Azevedo
authors.forename: Giovani Generali
authors.initials: GG
authors.lastname: Tomasetto
authors.forename: Carlos Henrique Gervini
authors.initials: CH
authors.lastname: Muniz
authors.forename: Jacó
authors.initials: J
authors.lastname: Lavinsky
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000628:therapy*; D004311:Double-Blind Method; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D058449:Intravitreal Injections; D017075:Laser Coagulation; D008269:Macular Edema / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage*; D014792:Visual Acuity
chemical_list: D005938:Glucocorticoids; D014222:Triamcinolone Acetonide