Abstract
Abstract: :
Purpose: To compare the short–term efficacy of IVTA injections in the treatment of chronic macular edema secondary to group 1: DR and group 2: CRVO. Methods: We included 24 eyes of 24 consecutive patients affected by macular edema without evidence of vitreo–retinal interface anomalies on optical coherence tomography (OCT), refractory to laser photocoagulation. Group 1 consisted of 14 diabetic patients, mean age 46.7 yrs ± 14.6, 36 % type I diabetes with mean duration 12,6 yrs ± 5.8. Group 2 was composed by 10 patients, 54.4 yrs ± 19.8 who had experienced CRVO from 6 to 12 months earlier. All the patients had been treated with macular laser photocoagulation from at least 3 months; none of them had evidence on fluorescein angiography of peripheral ischemia. 4 mg–triamcinolone acetonide was injected intravitreally, and controls (ophthalmological examination, fundus photography, and OCT) were planned at days 0, 7, 30, 90, 180. Fluorescein angiography was planned at days 30, 90, 180. Results: One week after injection, macular thickness significantly decreased (mean Δ thickness: –316,8 µ ± 159 in group 1, p < 0,001 and –283,9 µ ± 133 in group 2, p < 0,001) and visual acuity (VA) significantly increased in both groups (mean ΔVA : 0,18 ± 0,17, p < 0,001 vs 0,14 ± 0,17, p = 0,02). After 1 months, results were similar (mean Δ thickness: –357.3 µ ± 149.4 group 1, p <0,001 and –331 µ ± 124 group 2, p <0,001 ; mean ΔVA: 0,23 ± 0,18 p <0,01 vs 0,18 ± 0,22 p = 0,03); 79 % of group 1 and 50 % of group 2 had an improvement in VA. VA decreased only in 1 patients for each group. Pearson’s coefficent was –0,27 and –0,02 for group 1 respectively at days 7 and 30 and –0,77 and –0,59 for group 2. Conclusions: IVTA can rapidly and significantly reduce macular thickness and improve VA in chronic macular edema refractory to laser photocoagulation due either to DR or CRVO. Longer follow–up results would enable the assessment and duration of the effectiveness of these treatment
Keywords: diabetic retinopathy • drug toxicity/drug effects • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)