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I. Zundane, R. Adam, T. Rodallec, G. Dubernard, M. Belis, J.P. Nordmann, H. Offret, M. Labetoulle; No Amelioration of ISCEV ERG 1 Month After Intravitreal Triamcinolone Acetonid Injection for Diabetic Cystoid Macular Edema – An Oct3 and ISCEV ERG Study . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3837.
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to evaluate by means of OCT and ISCEV ERG the efficacy of intravitreal triamcinolone acetonid injection in diabetic patients with cystoid macular edema
10 eyes of 8 patients with severe diabetic retinopathy and impairment of visual acuity were observed prospectively. All included patients had clinically significant diabetic cystoid macular edema. Complete ophthalmological examination including best corrected visual acuity, fundus examination, tonometry, fluorescein angiography, OCT and ISCEV ERG recording was performed for all patients. All eyes were treated with intravitreal injection of 4mg of triamcinolone acetonide. Both eyes of each patient were controlled before intravitreal injection of triamcinolone acetonide and at one month after treatment
mean age was 60.6 years (± 6.1). Five of eight patients were female and 5 were left eyes. The mean visual acuity of injected eye was 1.23±0.46 (Log MAR) before injection of triamcinolone acetonide. The mean foveal thickness of injected eye was 624 µm±131 before injection. The mean amplitude of cone–ERG in ISCEV ERG of injected eye was 35.88µV±12.3 before treatment . The mean amplitude of flicker ERG in ISCEV of injected eye was 49.85 µV±17.76 before treatment. At one month after the treatment the mean visual acuity was 0.6±0.66 (Log MAR). The mean foveal thickness of injected eye was 260 µm±54 one month after treatment. The mean amplitude of cone–ERG in ISCEV ERG of injected eye was 31,88 µV±11,11 one month after injection. The mean amplitude of flicker ERG in ISCEV ERG of injected eye was 26,44 µV±8,94 one month after injection.
There was a significant amelioration of visual acuity detected one month after the treatment (p=0.0002). It was a significant reduction of macular thickness one month after triamcinolone acetonide intravitreal injection (p= 0.0006). There was no significant change of Cone–ERG 1 month after the treatment (p= 0.24). Moreover it was a significant deterioration of flicker ERG detected 1 month after triamcinolone acetonide intravitreal injection (p=0.02)
although visual acuity and OCT findings reflect efficacy of triamcinolone acetonide in treatment of diabetic cystoid macular edema, ISCEV ERG findings suggest no electrophysiologic recovery of photoreceptors in patients with severe diabetic cystoid macular edema and difficulties with diabetes equilibration 1 month after intravitreal triamcinolone injection.
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