Abstract
Purpose: :
To report 3-year outcomes of macular laser photocoagulation following intravitreal injection of 4 mg of triamcinolone acetonide (IVTA) for diffuse diabetic macular edema (DME).
Methods: :
Eighty-six eyes of 75 patients with diffuse DME were randomized into 2 groups. The eyes assigned to the combination group (n=48) were subjected to macular laser photocoagulation 3 weeks after IVTA. The eyes in the IVTA group (n=38) underwent IVTA alone. Central macular thickness (as measured by optical coherence tomography), the number of additional treatments, and the mean time to recurrence of DME were evaluated.
Results: :
Thirty-seven eyes in the combination group and 26 eyes in the IVTA group completed the 3-year follow-up. Nine of 37 eyes (24.32%) in the combination group and 1 eye of 26 (3.85%) in IVTA group showed no recurrence of DME after initial treatment (P=0.028). Macular edema was not present for 19.88 months in the combination group after treatment compared to 10.33 months in the IVTA group (P = 0.027). The mean number of additional treatments was 0.92 in the combination group and 1.88 in the IVTA group (P = 0.001).
Conclusions: :
The results in the subset of subjects who completed the 3-year follow-up demonstrated that combination therapy is more effective for diffuse DME than IVTA monotherapy. Combination therapy required fewer additional treatments and showed a lower recurrence rate than IVTA monotherapy.
Keywords: diabetic retinopathy • edema • laser