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V.M. Cohen, R.K. Obikpo, A.M. Glenn, C.D. Jones; The Efficacy of Intra–vitreal Triamcinolone for the Treatment of Macular Oedema in Diabetic Maculopathy and Non–ischaemic Central and Branch Retinal Vein Occlusions . Invest. Ophthalmol. Vis. Sci. 2005;46(13):1440.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:To record the incidence of clinical resolution of macular oedema following a single intra–vitreal triamcinolone injection and correlate this with visual outcomes Methods: Patients with persistent diabetic macular oedema following previous argon grid laser photocoagulation and non–ischaemic central and branch retinal vein occlusions were selected for treatment with intra–vitreal steroid. Patients who had coexisting glaucoma or ocular hypertension were excluded. 4 mg /0.1 ml of unfiltered triamcinolone was administered as a single pars planar intra–vitreal injection under topical anaesthesia. The patients were seen one week and then monthly post injection. Macular oedema was monitored clinically using a fundus viewing contact lens. Visual acuity was recorded on the ETDRS chart and converted into Log Mar and snellen vision for analysis. Results:Complete documentation was available in 51 eyes. The maximum follow up was 13 months (mean 5 months.) 39 eyes were treated for diabetic macular oedema. The remaining cases had macular oedema secondary to non–ischaemic vein occlusions, 7 branch retinal vein occlusion (BRVO) and 5 central retinal vein occlusions (CRVO) were treated. Biomicroscopic resolution of macular oedema was seen in 80% (4 out of 5) of the CRVO group, 71% (5 out of 7) of the BRVO group and 77% (30 out of 39) of the diabetic maculopathy group. Biomicroscopic resolution of macular oedema was associated with visual improvement in all eyes treated with retinal vein occlusions and 67% (20 out of 30) of eyes with diabetic macular oedema. Fluorescein angiography revealed ischaemia in the patients with no visual improvement. The most dramatic visual improvement was seen in the CRVO group. Following successful treatment visual acuity improved by 2 snellen lines or more in 75% of the CRVO group, 40% of the BRVO group and 35% of eyes with diabetic maculopathy. Complications included one sterile endophthalmitis and two cases of elevated intraocular pressure that required treatment.Conclusions: Intravitreal triamcinolone appears to be an effective and safe way of treating macular oedema and is usually associated with visual improvement when there is no significant ischaemia.
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