Efficacy of Sub-Tenon Triamcinolone Acetonide to Prevent Macular Edema After Panretinal Photocoagulation for Proliferative Diabetic Retinopathy

Abstract

Purpose: : To evaluate the effectiveness of sub-tenon triamcinolone acetonide (STTA) in preventing macular edema after panretinal photocoagulation (PRP) for proliferative diabetic retinopathy.

Methods: : Twenty milligrams of TA was injected into the posterior sub-tenon’s capsule before panretinal photocoagulation in 16 eyes of 10 patients (age, mean 55 years; range, 40 to 69 years) with proliferative diabetic retinopathy. Patients had a complete ophthalmic evaluation including visual acuity and optical coherence tomography (OCT) at baseline and at follow-up visits.

Results: : The follow-up period was >3 months in all eyes. The mean best-corrected visual acuity improved from 0.30 at baseline to 0.23 logMAR units at 3 month after STTA. The mean foveal thickness (FT) was 361±170 µm at baseline and 363±183 µm at 3 month. After 3 month, 5 eyes of 4 cases had a reduction of FT >20%, 8 eyes of 5 cases did not change (<±20%), and 3 eyes of 3 cases had an increase in the FT >20% compared to the baseline. No adverse side-effects were observed following TA.

Conclusions: : Posterior sub-Tenon’s capsule injection of 20 mg TA performed before PRP for proliferative diabetic retinopathy may prevent the PRP-induced macular edema and a reduction of vision.

Keywords: diabetic retinopathy • macula/fovea • drug toxicity/drug effects