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soheir Mohamed Esmat Mahmoud Ali, ; Optical coherence Tomography (OCT) to evaluate treatment of Diabetic macular edema using intravitreal injection of triamcinolone and argon laser treatment. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6359.
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© ARVO (1962-2015); The Authors (2016-present)
To Evaluate the efficacy of intravitreal injection of triamcinolone followed by macular grid argon laser treatment of to reduce retinal thickness and resolving of diabetic macular edema
The study included 60 eyes of D patients having macular edema, diagnosed by OCT to have central foveal thickness more than 350 microns. Exclusion criteria were IOP above 18 mmHg. proliferative diabetic retinopathy. previously operated or laser treated eyes and. Each eye had: 1-Preoperative: Fundus examination, OCT to measure central foveal thickness (CFT), to evaluate stage and type of macular edema, presence of neurosensory detachment, IS/OS segment integrity, IOP and BCVA. 2- intravitreal injection of 2mg in 0.05ml followed up closely for IOP.3- OCT after 21 days of injection. 3- Argon laser was scheduled to eyes where CFT below 250 microns in a C Grid pattern having spot size 100 microns, duration of 200msec and power of 120-200mWatt 4- Eyes with CFT more than 250 mic were subjected to another session of triamcinolone intravitreal injection after 1 month following first injection then measurement of CFT by OCT after 21 days then C Grid pattern laser treatment if CFT was reduced below 250 microns. Results were recorded and statistically analyzed.
The study included 60 eyes of 60 NIDD. 35 males and 15 females: 30 eyes had combined diffuse and cystoid macula edema (ME), 14 eyes had only cystoid ME and 16 eyes had only diffuse ME. Mean CFT was +/- 510mic. 72% of eyes having combined diffuse and cystoid ME had CFT below 250 mic after one injection while 20% required a second injection while 8% did not give a significant response so not scheduled for laser tereatment. 64% eyes having cystoid ME had CFT below 250 mic after one injection while 14% required a second injection while 22% did not give a significant response so not scheduled for laser treatment. 84% eyes having diffuse ME had CFT below 250 mic after one injection while 8 % required a second injection while 8% did not give a significant response so not scheduled for laser treatment. 85% of resistant cases shoed preoperative neurosensory detachment. 15% had elevation of IOP that responded to antiglaucoma treatment.
Triamcinolone followed by laser treatment is an efficient method for treating different types of diabetic macular edema in patients of IOP below 18 mmHg.
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