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J.G. Conrath, J. Gaudart, A. Lecleire–Collet, A. Erginay, A. Gaudric, P. Massin; Predictive Factors Of Macular Thickness After Intravitreal Triamcinolone Injection For Diabetic Macular Edema . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3858.
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To analyse predictive factors of anatomical efficacy in treatment of diabetic macular edema by a single intravitreal triamcinolone acetonide injection.
A retrospective study of 74 eyes in 74 patients was undertaken. Mean outcome measure of efficacy was central macular thickness at 6 months (less than or equal to 300 µm measured by OCT). The following parameters were assessed, at baseline: sex, age, type of diabetes, number of grid laser treatments, triamcinolone dose (2 mg or 4 mg), pre–injection visual acuity, OCT aspect of macular edema (serous macular detachment, multiple or single macular cysts), HbA1c level, DR stage, diabetes duration and macular edema duration, presence or absence of arterial hypertension, and both at baseline and at months 1, 3 and 6: macular thickness, VA and IOP. Statistical analysis was performed with the SPSS 11.1 software, using logistic regression (stepwise procedure based on the likelihood ratio) was performed after univariate analysis for covariate selection (alpha=0.25) using chi2 for qualitative covariates (or Fisher exact test if necessary) and student t test for quantitative covariates (or Wilcoxon test if necessary).
Sex ratio was 41M:33F. Average age was 61 years and 83% were type 2 diabetics. Multivariate logistic regression showed 2 variables to be predictive of macular thickness to be less than 300 µm at 6 months: IOP (relative risk 1.29 for each mmHg of increased IOP, p=0.013) and absence of arterial hypertension (relative risk 6.06, p=0.012).
This retrospective study showed that presence of arterial hypertension played a role in recurrence of macular edema at 6 months post–intravitreal triamcinolone injection for DME. On the contrary, higher IOP was associated with better anatomical results.
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