Abstract
Purpose:
To identify the risk factors for a recurrence and/or a persistence of diabetic macular edema (DME) after sub-Tenon capsule triamcinolone acetonide (STTA) injection.
Methods:
All of the procedures conformed to the tenets of the World Medical Association Declaration of Helsinki. The medical records of 124 patients (124 eyes) treated by STTA were reviewed. Seventy-four patients (59.7%; 42 men, 32 women) had a persistent DME or a recurrence within a year. The age, sex, HbA1c, best-corrected visual acuity (BCVA), central macular thickness (CMT), insulin use, pioglitazone use, hypertension, serous retinal detachment (SRD), diabetic nephropathy, pan-retinal photocoagulation (PRP), microaneurysm photocoagulation (MAPC), subthreshold micropulse diode laser photocoagulation (SMDLP), cataract surgery, and history of vitrectomy were examined by logistic regression analysis.
Results:
At the time of treatment, the mean age was 61.5±13.0 years, mean HbA1c was 6.8±1.3%, mean BCVA was 0.6±0.4 logMAR units, and mean CMT was 557.2±143.7um. Twenty-three patients (31.1%) used insulin, 8 used pioglitazone (10.8%), 33 patients (44.6%) had hypertension, and 29 patients (39.2%) had nephropathy. Thirty-three patients (44.6%) underwent PRP and 15 patients (20.3%) underwent cataract surgery. These factors were found not to be risk factors. Thirty-five patients (47.3%) underwent MAPC and 11 patients (14.9%) underwent SMDLP combined with STTA. These procedures were determined to be significantly associated with DME treated with STTA (P=0.0315, P=0.04, respectively). However, 7 patients (9.5%) with a history of PPV were found to have significantly fewer recurrences and/or persistent DME after STTA (P=0.0464).
Conclusions:
Patients who had combined MAPC and SMDLP had significantly higher refractoriness to DME after STTA, but avitreous may prevent the recurrence and/or persistent DME after STTA.
Keywords: 499 diabetic retinopathy •
505 edema •
585 macula/fovea