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M.R. Heimmel, D.B. Roth, D.L. Yarian, S.N. Green, S.R. Leff, E.S. Friedman, B.J. Keyser, H.M. Wheatley; Intravitreal Triamcinalone Acetonide (IVT) for the Treatment of Diabetic Macular Edema . Invest. Ophthalmol. Vis. Sci. 2005;46(13):1451.
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Purpose: To determine the efficacy of intravitreal triamcinolone acetonide (IVT) injection in patients with diabetic macular edema. Methods: A retrospective review of 319 patients (434 eyes) receiving 1 mg to 4 mg of IVT was conducted. The main outcome measures included Snellen visual acuity, the clinical appearance of macular edema, and macular leakage on fluorescein angiography. Patients were followed at 1–month, 3–month, 6–month, and 12–month intervals. Results: Of the 434 eyes with macular edema analyzed in this study, 321 eyes received laser treatment and 129 patients underwent cataract extraction prior to IVT injection. At 3 months following initial IVT injection, 29.8% of eyes gained 2 or more lines of Snellen visual acuity, 56.7% were the same, and 13.5% worsened by 2 or more lines of Snellen visual acuity. At 6 months following initial IVT injection, 27.6% of eyes gained 2 or more lines of Snellen visual acuity, 56.3% were the same, and 16.1% worsened by 2 or more lines of Snellen visual acuity. At 3 months, macular edema resolved in 21% of eyes, improved in 32% of eyes, was unchanged in 34% of eyes, and worsened in 13% of eyes. At 6 months, macular edema resolved in 15% of eyes, improved in 27% of eyes, was unchanged in 32% of eyes, and worsened in 26% of eyes. 146 eyes required laser treatment and 148 eyes needed at least one additional IVT injection during follow–up. The mean number of repeat IVT injections was 0.37. Conclusions: Intravitreal triamcinolone acetonide injection appears to be a useful treatment modality for diabetic macular edema. Multiple injections may be necessary in order to induce resolution of macular edema. A randomized clinical trial, currently enrolling patients, will yield useful further data as to the indication of IVT in the treatment of diabetic macular edema.
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