April 2009
Volume 50, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2009
Changes in the Photoreceptor Layer Integrity and Its Relation to Visual Acuity in Patients Treated With Intravitreal Triamcinolone Acetonide Injection for Diabetic Macular Edema
S. Yoshida; H. Oh; K. Nishijima; A. Sakamoto; N. Unoki; H. Hayashi; S. Nakagawa; Y. Makiyama; M. Kita; N. Yoshimura
Author Affiliations & Notes
  • S. Yoshida
    Opthalmology & Visual Science, Kyoto university, kyoto, Japan
  • H. Oh
    Opthalmology & Visual Science, Kyoto university, kyoto, Japan
  • K. Nishijima
    Opthalmology & Visual Science, Kyoto university, kyoto, Japan
  • A. Sakamoto
    Opthalmology & Visual Science, Kyoto university, kyoto, Japan
  • N. Unoki
    Opthalmology & Visual Science, Kyoto university, kyoto, Japan
  • H. Hayashi
    Opthalmology & Visual Science, Kyoto university, kyoto, Japan
  • S. Nakagawa
    Opthalmology & Visual Science, Kyoto university, kyoto, Japan
  • Y. Makiyama
    Opthalmology & Visual Science, Kyoto university, kyoto, Japan
  • M. Kita
    Opthalmology & Visual Science, Kyoto university, kyoto, Japan
  • N. Yoshimura
    Opthalmology & Visual Science, Kyoto university, kyoto, Japan
  • Footnotes
    Commercial Relationships  S. Yoshida, None; H. Oh, None; K. Nishijima, None; A. Sakamoto, None; N. Unoki, None; H. Hayashi, None; S. Nakagawa, None; Y. Makiyama, None; M. Kita, None; N. Yoshimura, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2009, Vol.50, 1318. doi:
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      S. Yoshida, H. Oh, K. Nishijima, A. Sakamoto, N. Unoki, H. Hayashi, S. Nakagawa, Y. Makiyama, M. Kita, N. Yoshimura; Changes in the Photoreceptor Layer Integrity and Its Relation to Visual Acuity in Patients Treated With Intravitreal Triamcinolone Acetonide Injection for Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1318.

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Abstract

Purpose: : To study the correlation between visual acuity and the integrity of photoreceptor layer reported on spectral domain optical coherence tomography (SD-OCT) before and after intravitreal triamcinolone acetonide (IVTA) injection for diabetic macular edema.

Methods: : We retrospectively reviewed the medical records of 22 eyes of 20 patients who received a single IVTA (4mg) injection for diabetic macular edema and followed for at least 3 months. The status of the photoreceptor inner segment/ outer segment junction (IS/OS) and the external limiting membrane (ELM) documented with SD-OCT were classified into 3 groups as continuous, discontinuous, and defective.

Results: : The mean foveal thickness significantly decreased from 418 µm to 247 µm (p<0.01) and logMAR visual acuity (VA) improved from 0.42 to 0.29 (p<0.01) 3 months after IVTA. In eyes with preoperative continuous or defective IS/OS junction, the postoperative status remained the same. A similar trend was observed with ELM. Eyes with preoperative defective integrity of either IS/OS or ELM had significantly worse preoperative and postoperative VA compared to the remaining groups (0.73 vs 0.22 for IS/OS, 0.66 vs 0.22 for ELM, p<0.05 for both IS/OS and ELM). Five out of 17 eyes and 4 out of 18 eyes with preoperative discontinuous integrity of IS/OS junction and ELM, respectively, improved to be continuous postoperatively. In regard to IS/OS, these eyes had significantly better postoperative VA compared to those that remained unchanged (0.19 vs 0.39, p<0.05). However, a similar trend was not observed with ELM.

Conclusions: : The overall integrity of both IS/OS and ELM reflect well both the preoperative and postoperative VA. The preoperative status of the photoreceptor layer integrity can partly predict its postoperative one. About 20% of the eyes showed an improvement in the integrity of photoreceptor layer in terms of the IS/OS junction or the ELM after IVTA. In the preoperative discontinuous IS/OS group, improvement of this structure after treatment may have a role in postoperative VA.

Keywords: diabetic retinopathy • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • injection 
© 2009, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2025 Association for Research in Vision and Ophthalmology.
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