Abstract
Purpose: :
To determine the effect of intravitreal triamcinolone acetonide on alterations of macular thickness and visual acuity during and after panretinal photocoagulation (PRP) in patients with proliferative diabetic retinopathy (PDR).
Methods: :
Forty–one eyes of 37 patients underwent optical coherence tomography (OCT) and divided into 2 groups. Patients with macular thickness less than 300 µm belong to group A and patients with macular thickness over 300 µm belong to group B. Group A and B were divided again into IVTA group and control group, whether the patients underwent intravitreal triamcinolone acetonide injection before PRP or not. The argon laser photocoagulation was performed weekly in 3 to 5 sessions. The macular thickness was measured with OCT and the visual acuity measured with ETDRS chart at each PRP session, 8, and 16 weeks after start of PRP.
Results: :
In group A, the macular thickness increased transiently but the visual acuity was maintained. The IVTA group showed smaller amount of increase in the macular thickness than control group but there was no statistical differences. In group B, the macular thickness increased during and after PRP and was accompanied by decrease of visual acuity in control group. The IVTA group showed significant decrease of macular thickness during PRP.
Conclusions: :
The macular edema was exacerbated during and after PRP and the visual acuity was affected. The intravitreal triamcinolone acetonide allowed less increase of macular thickness following PRP. The intravitreal triamcinolone acetonide injection before PRP may provide benefit in patient with diabetic macular edema who requires PRP for PDR.
Keywords: diabetic retinopathy • drug toxicity/drug effects • retina