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P.W. Park, E. Mavrofrides, W.F. Mieler, E.R. Holz; Pilot Study of Intravitreal Injection of Triamcinolone Acetonide for Refractory Diabetic Macular Edema . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3966.
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Purpose: To investigate whether intravitreal injection of triamcinolone acetonide in patients with refractory diabetic macular edema will result in positive visual and clinical outcomes in a safe manner. Methods: A prospective pilot clinical trial of a single injection of triamcinolone acetonide (4mg/0.1ml) into the vitreous cavity of experimental eyes at baseline in patients with refractory diabetic macular edema. Complete ocular examination with LogMAR visual acuity assessment was performed at baseline, 1 day, 1, 4, and 7 months following enrollment. Fluorescein angiography was performed at baseline, 4, and 7 months. In addition, Optical Coherence Tomography (OCT) was performed on selected patients at baseline, 4 and 7 months. Results: Six out of eight treatment eyes showed LogMAR visual acuity improvement at 1 month follow-up (-0.23). Four and seven month follow-up revealed that the 6 treatment eyes experienced a gradual decline in LogMAR visual acuity toward baseline levels. Fluorescein angiography revealed stability or improvement with reduction of leakage in the treatment eyes at 1 month, with gradual increase in leakage at subsequent follow-ups. OCT revealed significant reduction of macular edema in the treatment eyes at 1 month with increasing macular edema at subsequent follow-ups. Two treatment eyes developed sterile, culture negative endophthalmitis; however, the vision was stable throughout the study for both patients. None of the treated eyes developed increased intraocular pressure or cataract progression. Conclusions: Intravitreal triamcinolone appears to be well-tolerated and may provide visual improvement in patients with refractory diabetic macular edema. The effect appears to persist up to 4 months. .
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