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A. Ramoni, R. Lattanzio, G. Tremolada, E. Bruschi, F. Legorini, U. Introini, R. Brancato; Baseline Visual Acuity as a Short Term Prognostic Factor for the Treatment of Chronic Diabetic Macular Edema With Intravitreal Triamcinolone Acetonide (IVTA) . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3864.
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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.
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.
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).
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.
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