[Intravitreal triamcinolone combined with grid laser photocoagulation for patients with cystoid macular edema and advanced diabetic retinopathy: pilot study].
BACKGROUND
To determine if primary intravitreal injection of triamcinolone acetonide (TA) plus grid laser photocoagulation (GLP) is effective in treating cystoid diabetic macular edema (DME).


METHODS
Prospective comparative non-randomized clinical trial. Fourteen eyes (14 patients) diagnosed with cystoid DME were treated with GLP according to the Early Treatment Diabetic Retinopathy Study (ETDRS) guidelines, plus an intravitreal injection of 4 mg of TA. A matched control group (16 eyes [16 patients]) treated with GLP was selected retrospectively from our medical records. Best-corrected visual acuity (BCVA), and quantitative change in optical coherence tomography (OCT) macular thickness were assessed.


RESULTS
Mean follow up was 14.9 months (12 to 19 months). In 3 (21.4%) eyes BCVA increased > 2 ETDRS lines, in 5 (35.7%) eyes BCVA remained the same, and BCVA decreased >2 ETDRS lines in 6 (42.8%) eyes. Central macular thickness, as measured by OCT, decreased a mean of 106.2 μm (30.2%). The difference with the control group was not statistically significant (P = .2). Four (28.5%) eyes developed an increased in intraocular pressure in our study group.


CONCLUSIONS
Although all of our patients showed an improvement of cystoid DME by means of OCT and fluorescein angiography, 42.8% (6 eyes) lost 2 or more lines in BCVA with primary intravitreal injection of TA plus GLP. Primary intravitreal injection of TA plus GLP may not be effective for cystoid DME at 12-months.
División de Retina, Wilmer Eye Institute, Escuela de Medicina de la Universidad de Johns Hopkins, Baltimore, MD, EE. UU.; King Khaled Eye Specialist Hospital, Riad, Arabia Saudí. Electronic address: arevalojf@jhmi.edu.
J F
JF
Arévalo
C F
CF
Fernández
A J
AJ
Mendoza
R A
RA
García
F A
FA
Arévalo
D000368:Aged; D003131:Combined Modality Therapy; D003930:Diabetic Retinopathy / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D058449:Intravitreal Injections; D017075:Laser Coagulation / Q000009:adverse effects; D008269:Macular Edema / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D009798:Ocular Hypertension / Q000139:chemically induced; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D014792:Visual Acuity
D014222:Triamcinolone Acetonide
Combined therapy; Diabetic retinopathy; Diffuse cystoid diabetic macular edema; Edema macular diabético quístico difuso; Fotocoagulación láser en rejilla; Grid laser photocoagulation; Intravitreal triamcinolone acetonide; Retinopatía diabética; Terapia combinada; Triamcinolona intravítrea