Purchase this article with an account.
K. Waheed, G.M. Orr, S. Lake, R. Vazirinejad, A.G. Zaman; Intravitreal Triamcinolone for refractory diabetic macular oedema. . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4102.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine the effects on final visual outcome, intraocular pressure and macular fluorescein leakage after intravitreal injection of triamcinolone for treating refractory Diabetic macular Oedema. Methods:Patients with Clinically significant macular oedema(CSMO) of more than 12 months duration, diagnosed according to EDTRS criteria were recruited. All patients had at least two or more macular grid laser treatment with the more recent laser at least 3 months prior to the injection.Patients with CSMO and active Proliferative disease, vein occlusions and macular ischaemia were excluded. Patients with preexisting significant cataract or glaucoma were also not considered.Triamcinolone, 4mg was injected through the pars plana infrotemporally using a 27 guage needle.The response to the treatment was monitored at 1month, 3 months and 6 months.Visual acuity was assessed by Log MAR units, Flourescein leakage by measuring the area of late phase digital fluorescein angiogram and intraocular pressure by Goldman's tonometry. Results:14 eyes of 13 patients were included in the study.The mean age was 68. All patients had an average of 2.4 previous sessions of grid laser treatment for CSMO.The mean visual acuity improved from 0.54 LogMAR units prior to the injection to 0.43, 0.40 and 0.37 LogMAR units at 1, 3 and 6 months post injection. This showed a statistically significant p–values of 0.042, 0.013 and 0.002 respectively.The mean intraocular pressure(IOP) increased from a preinjection value of 16.57 to 19.42, 22.07 and 21.50 at 1, 3 and 6 months post injection respectively. The p–value for this rise in IOP was also statistically significant at 0.035, 0.005 and 0.000 respectively. Evaluated subjectively in a masked fashion, macular post injection fluorescein angiograms of all 14 eyes (100%) were graded to show less leakage than on the preinjection angiograms in all 1, 3 and 6 months visits. No injection site related complications were noted. No patient had a repeat injection. Conclusions: Intravitreal triamcinolone has shown visually and anatomically encouraging results for the treatment of diabetic macular oedema that fails to repond to conventional laser photocoagulation. Raised intraocular pressure is a concern but longer followup is warrented to assess the efficacy and safety as well as need for retreatment.
This PDF is available to Subscribers Only