Abstract
Abstract: :
Purpose: To determine the clinical and OCT features of diabetic macular edema associated with better visual outcome after intravitreal Kenalog injection. Methods: Clinical characteristics and OCT findings of 28 eyes of 27 patients that received intravitreal Kenalog for diabetic macular edema were studied retrospectively. Correlation between the significant visual change (>2 lines) and patient age, gender, type and duration of diabetes, presence of concurrent medical conditions such as systemic hypertension and hypercholesterolemia, use of insulin, HbA1C level, duration of macular edema, history of previous focal laser treatment, presence of hard exudates, macular thickness and hydration on OCT were sought. Results: Visual acuity improved in 20/28 eyes. Age (p=0.15), gender (p=0.42), initial visual acuity (p=0.84), duration (p=0.12), type (p=1.0) and medical management (p=0.11) of diabetes, previous focal laser treatment (p=1.0), presence of hard exudates (p=0.63), number of Kenalog injections (p=0.83) had no predictive value on visual outcome. However, duration of macular edema (p=0.05), presence of hypertension (p=0.01), hyperlipidemia (p=0.03), HbA1C level (p=0.01), macular thickness on OCT (p=0.01) and disappearance of hard exudates (p=0.02) and were significant predictors of visual gain. There was a tendency of retinal hydration to be negatively correlated with visual outcome (p=0.08). Conclusions: Intravitreal Kenalog injection results are more favorable in patients with thicker macular edema for a shorter duration. Control of systemic medical conditions such as hypertension hyperlipidemia and blood glucose improves the visual outcome.
Keywords: diabetic retinopathy • imaging/image analysis: clinical • injection