April 2009
Volume 50, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2009
OCT and Visual Acuity in PDR Treated With Laser-Triamcinolone
Author Affiliations & Notes
  • O. O. Maia, Jr.
    Cli­nica Especializada em Retina e Vitreo, Sao Rafael Hospital - Monte Tabor Foudation, Salvador, Brazil
    Retina and Vitreous Service,
    University of Sao Paulo Medical School, Sao Paulo, Brazil
  • B. S. Takahashi
    Retina and Vitreous Service,
    University of Sao Paulo Medical School, Sao Paulo, Brazil
  • M. L. Monteiro
    Neuro-ophthalmology Service,
    University of Sao Paulo Medical School, Sao Paulo, Brazil
  • W. Y. Takahashi
    Retina and Vitreous Service,
    University of Sao Paulo Medical School, Sao Paulo, Brazil
  • Footnotes
    Commercial Relationships  O.O. Maia, Jr., None; B.S. Takahashi, None; M.L. Monteiro, None; W.Y. Takahashi, None.
  • Footnotes
    Support  ARVO International Travel Grants
Investigative Ophthalmology & Visual Science April 2009, Vol.50, 191. doi:
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      O. O. Maia, Jr., B. S. Takahashi, M. L. Monteiro, W. Y. Takahashi; OCT and Visual Acuity in PDR Treated With Laser-Triamcinolone. Invest. Ophthalmol. Vis. Sci. 2009;50(13):191.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To evaluate the correlation between ETDRS best-corrected visual acuity (BCVA) and central macular thickness (CMT) in eyes with moderate proliferative diabetic retinopathy (PDR) treated with laser (pan-retinal and macular) photocoagulation and intravitreal triamcinolone acetonide (IVTA) injection.

Methods: : Prospective, interventional case-series. Twenty-eight eyes from 28 patients with treatment-naive moderate PDR were submitted to pan-retinal and macular laser photocoagulation according to the EDTRS guidelines. After completion of pan-retinal photocoagulation treatment at week 3, all eyes were assigned to receive a single 4 mg IVTA injection (Kenalog®40; triamcinolone acetonide injectable suspension, USP, Bristol-Myers Squibb Company). BCVA, digital color fundus photography, CMT measured using optical coherence tomography (Stratus® Tomographer, Model 3000, Carl Zeiss Meditec, Dublin, California, USA) was performed in all patients at baseline and at months 1, 3, and 6 after treatment. BCVA and CMT measurements before and after treatment were compared. Spearman’s rank correlation coefficients were used to evaluate the relationship between BCVA and CMT measurements.

Results: : At baseline, average CMT was 326.0 ± 101.1 µm (mean ± standard deviation), and BCVA was 0.37±0.20. After treatment, CMT decreased significantly to 242.2±35.1 (P< 0.001), 231.4±31.2 (P< 0.001), and 231.4±33.2 µm (P< 0.001) at 1, 3, and 6 months, respectively, as compared to baseline measurements (Wilcoxon signed ranks test). BCVA improved to 0.20±0.13 (P< 0.001), 0.15±0.09 (P< 0.001), and 0.14±0.08 (P< 0.001) at 1, 3, and 6 months after treatment, respectively (Wilcoxon signed ranks test). Improvement in BCVA was followed by a significant reduction in CMT at 1, 3 and 6 months follow up when compared to baseline measurements (P < 0.001, ANOVA). There was a strong correlation between BCVA improvement and reduction of CMT (ρ = 0.527, P= 0.004) (ρ = 0.423, P= 0.025) (ρ = 0.564, P= 0.002), at 1, 3, and 6 months, respectively (Spearman's correlation coefficient).

Conclusions: : A single injection of IVTA as an adjuvant to laser treatment was effective in reducing CMT and improving BCVA in eyes with moderate PDR. A strong correlation between CMT reduction and improvement in BCVA in these patients with no previous treatment of the diabetic retinopathy was observed. A larger sample with longer follow-up is warranted to confirm our findings.

Clinical Trial: : www.clinicaltrials.gov NCT00443521

Keywords: laser • macula/fovea • edema 
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