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Gian Santos Pierozzi, Thiago Leite Albuquerque, Arnaldo Furman Bordon, Marcia C Martins; Pars Plana Vitrectomy and 2 mg Triamcinolone Acetonide for Macular Edema due to Epiretinal Membrane.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1130.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the additive effect of triamcinolone acetonide (TAAC) to pars plana vitrectomy (PPV) in patients with macular edema due to epiretinal membrane (ERM).
prospective, pilot, interventional study. Patients with macular edema due to mainly non-idiopathic ERM were submitted to PPV with 2 mg TAAC intra-vitreal injection at the end of surgery. Follow-up was done at D7, D30, D60, D90, and D180 after surgery. Main inclusion criteria: age ≥ 18 years-old, OCT-proven ERM with central macular thickness (CMT) > 300 µm. Main exclusion criteria: macular edema due to any other cause, active uveitis, and uncontrolled glaucoma or disk cup size ≥ 0.6. OCT was performed before surgery and at each follow-up. Primary objective is to analyze CMT variation measured by SD-OCT at D180. Secondary objective is to evaluate IOP and best corrected visual acuity (BCVA) variation from baseline to D180. This trial is register at https://eudract.ema.europa.eu (no 2013-005239-26), and approved by the Research Ethical Committee (no 01687112.8.0000.0088).
A total of 8 eyes of 8 patients were enrolled. The mean age was 63.5 years (45-74); 25% were female, and the left eye was affected in 5 cases (65.5%). Five eyes had idiopathic ERM and 3 eyes had ERM secondary to other causes (retinal detachment and proliferative diabetic retinopathy). Mean baseline BCVA was 0.75 logMAR, and the mean final BCVA was 0.86 logMAR (p<0.05). Mean CMT was, respectively: 378 µm (baseline), 352 µm (D30), 365 µm (D60), 371 µm (D90), and the 457 µm (D180). During follow-up, IOP did not raise over 25 mmHg in both groups. CMT was not statistically significant at D180 compared to baseline (p>0.05).
There was no improvement of the CMT using 2mg TAAC with pars plana vitrectomy for ERM. IOP was not increased with the use of 2mg TAAC. BCVA showed worsening at D180, however these results should be interpreted with caution, since, in our study, non-idiopathic ERM accounted for 37,5% of the cases and share physiopathological differences with idiopathic ERM which, ultimately, might have influenced the results along with the small sample of this pilot study.
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