April 2014
Volume 55, Issue 13
ARVO Annual Meeting Abstract  |   April 2014
Risk factors for refractory diabetic macular edema after sub-Tenon capsule injection of triamcinolone injection
Author Affiliations & Notes
  • Yuta Kitamura
    Chiba University, Chiba, Japan
  • Toshiyuki Oshitari
    Chiba University, Chiba, Japan
  • Sakiko Nonomura
    Chiba University, Chiba, Japan
  • Miyuki Arai
    Chiba University, Chiba, Japan
  • Eiju Sato
    Chiba University, Chiba, Japan
  • Yoko Takatsuna
    Chiba University, Chiba, Japan
  • Shuichi Yamamoto
    Chiba University, Chiba, Japan
  • Footnotes
    Commercial Relationships Yuta Kitamura, None; Toshiyuki Oshitari, None; Sakiko Nonomura, None; Miyuki Arai, None; Eiju Sato, None; Yoko Takatsuna, None; Shuichi Yamamoto, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 1776. doi:
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    • Get Citation

      Yuta Kitamura, Toshiyuki Oshitari, Sakiko Nonomura, Miyuki Arai, Eiju Sato, Yoko Takatsuna, Shuichi Yamamoto; Risk factors for refractory diabetic macular edema after sub-Tenon capsule injection of triamcinolone injection. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1776.

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      © ARVO (1962-2015); The Authors (2016-present)

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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  

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