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Y. Shimonagano, N. Doi, Y. Node, A. Uemura, T. Sakamoto; Effect of Intravitreous Injection of Triamcinolone After Vitrectomy for Diabetic Macular Edema . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3839.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the effect of intravitreous triamcinolone acetonide (TA) injection after pars plana vitrectomy (PPV) for diabetic macular edema (DME) compared with PPV alone.
A prospective study was performed on 28 eyes of 25 patients with DME according to the criteria. TA (4 mg) was injected intravitreously at the end of PPV (VT+TA group). Best–corrected visual acuity (BCVA) and mean foveal thickness evaluated by optical coherence tomography were followed up for over 12 months. All DME eyes that met with the same criteria (29 eyes of 27 patients) and treated by PPV alone last 1 year and those who disagreed to use TA were used as control (VT group). Chronological changes of BCVA and mean foveal thickness and the differences between two groups were evaluated
In VT+TA group, BCVA was improved at postoperative 1 month but worsened after 3 months due to recurrence of macular edema. Improvement of mean foveal thickness was found from 1 to 3 months, but not after 6 months. While in VT group, both mean BCVA and foveal thickness kept improved through the observation period. Compared with two groups, BCVA of VT+TA group was significantly better than VT group at postoperative 1 month (P= 0.007); mean foveal thickness of VT+TA group was significantly less than VT group at 1 month (P= 0.0004). These differences became insignificant thereafter, and foveal thickness became significantly worse in VT+TA group than in VT group at 12 months (P=0 .0002).
Although intravitreous TA at the end of PPV for DME improved BCVA and foveal thickness early postoperatively, the effect was transient and foveal thickness became significantly worsened in TA+VT group than VT group at postoperative 12 months inversely. An adjunctive use of TA after PPV might be less beneficial than PPV alone after a long period.
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