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A. Lecleire-Collet, J.-A. Pournaras, A. Erginay, A. Gaudric, P. Massin; Effect of Intravitreal Triamcinolone Injection on Refractory Diabetic Macular Edema : Anatomo-Functional Correlations. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4263.
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The study was performed in patients with diabetic macular edema refractory to laser treatment to assess the effect of intravitreal triamcinolone injection on functional and anatomical retinal parameters, and to correlate these functional and anatomical retinal parameters between them.
Twenty patients (twenty-two eyes) underwent, before and one month after an intravitreal injection of 4 mg triamcinolone, ETDRS visual acuity test, Pelli-Robson contrast sensitivity test, Cirrus Spectral Domain and Stratus Time Domain Optical Coherence Tomography (OCT) examinations.
The ETDRS visual acuity and contrast sensitivity scores, central macular thickness and macular volume using Cirrus and Stratus OCT were respectively : 47 ; 0.9 ; 633 ; 15.1 ; 568 ; 11.6 before injection and 51 (p<0.01); 1.09 (p<0.005) ; 317 (p<10-6);11.6 (p<10-4); 291(p<10-6) ; and 9 (p<0.01) after injection. A reappearance of the line of junction of the photoreceptor cell segments on OCT was present in 6 eyes (27%) after injection. The correlations between the functional data (visual acuity and contrast sensitivity) and the anatomical data (macular thickness and macular volume using OCT) were mild before injection and poor after injection (Spearman test). The correlations between the increase in visual acuity and the decrease of retinal thickness using OCT, and between the visual acuity after injection and the reappearance of the photoreceptor cell segments were mild (r = 0.47 et 0.33, respectively).
In patients with refractory diabetic macular edema, the functional parameters (visual acuity, contrast sensitivity) and the anatomical parameters (OCT) are significantly improved by intravitreal triamcinolone injection, but are mildly or poorly correlated between them. The new microperimetry associated with OCT/SLO device may better assess the links between structure and function in diabetic macular edema.
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