Abstract
Purpose: :
To evaluate if baseline visual acuity can be used to predict the 6 months efficacy of IVTA in the treatment of chronic diabetic macular edema refractory to laser photocoagulation.
Methods: :
We included 23 consecutive diabetic patients affected by chronic macular edema refractory to laser photocoagulation without vitreo–retinal interface abnormalities (as demonstrated by Optical Coherence Tomography – OCT) and divided them in three groups on the basis of their visual acuity: group 1: < 0,2; group 2: ≥ 0,2 & ≤ 0,3; and group 3: > 0,3. The three groups consisted respectively of 7, 8 and 8 patients. We injected intravitreally 4 mg of triamcinolone acetonide and scheduled controls (best corrected visual acuity, complete ophthalmological examination, retinography and OCT) at days 7,30,90,180.
Results: :
Baseline mean VA was 0,06 ± 0,03 for group 1, 0,27 ± 0,05 for group 2 and 0,5 ± 0,07 for group 3. After 6 months, visual acuity significantly increased only in group 2 (mean ΔVA 0,24 ± 0,26; p = 0,03) and in group 3 (mean ΔVA 0,21 ± 0,15; p = 0,006), while in group 1 the difference was no statistically significant (mean ΔVA 0,12 ± 0,24; p = 0,23).
Conclusions: :
Our data suggest that IVTA is associated with an improvement in visual acuity after 6 months unless baseline visual acuity is too poor. Longer follow up and greater trials should be done in order to confirm this hypotesis.
Keywords: diabetic retinopathy • drug toxicity/drug effects