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D. D. Tran, R. Sjaarda; Focal Laser Photocoagulation Following Triamcinolone Acetonide for Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1428.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the clinical outcome of focal laser photocoagulation of the macula following 4 mg of intravitreal triamcinolone acetonide (IVTA) injection for diabetic macular edema (DME).
Retrospective review of a consecutive case series of eyes undergoing IVTA and subsequent focal laser photocoagulation for clinically significant diabetic macular edema with foveal thickening. Snellen visual acuity was converted to logMAR for statistical analysis. Serial optical coherence tomography (OCT) measurements, when available, were statistically analyzed. Intraocular pressure (IOP) and lens opacity scores were followed. Patient complications were compiled.
32 eyes of 27 patients were included in this study. Mean follow up was 1.76 months (1.25 to 2.25). Mean initial acuity was 0.68 logMAR (~20/100)(range:0.3 to 1.30). Mean final acuity was 0.46 logMAR (~20/60)(range: 0.18 to 1.30) with mean improvement 0.2244 logMAR (3 lines on the Snellen chart)(range: -0.12 to 0.70). Initial and final OCT measurements were available in 14 of 32 eyes (43%). Mean initial thickness in the central subfield was 457.79 microns (300- 632). Mean final thickness was 275.43 microns (164- 435) with the mean improvement 179.5 microns. 17 of 32 eyes (53%) underwent more than 1 combined/consecutive treatment; 6 eyes with IVTA + focal, 9 eyes with focal, and 2 eyes with IVTA. Complications were as follows: 6 eyes experienced a steroid response with elevation of IOP requiring topical agents only, 7 eyes developed or had progression of lens opacity with 2 eyes undergoing cataract extraction. No uveitis or endophthalmitis was observed.
Focal macular laser photocoagulation following IVTA appears to be effective in improving visually acuity and central macular thickness in eyes with diabetic macular edema and foveal thickening. Further studies need to corroborate and expand upon these results.
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