Abstract
Abstract: :
Purpose: To investigate the fluctuation of plasma glucose concentration after intravitreal and posterior sub–Tenon injection of triamcinolone for diabetic macular edema. Methods: In this a retrospective, interventional, non–comparative case series, 25 eyes of 25 patients (15 males and 10 females, age 62.5± 7.6 years, mean ± SD) undergoing pars plana vitrectomy for diabetic macular edema were studied. Triamcinolone acetonide 4 mg in 0.1 ml was injected into the vitreous cavity, and 20 mg in 0.5 ml into the posterior sub–Tenon space. All patients enrolled in the study had type II diabetes and had been managed with insulin for at least 1 year. Fasting and post–breakfast plasma glucose levels were measured preoperatively and daily for two weeks postoperatively. Results: Fasting plasma glucose level significantly increased by 3 days after vitrectomy and steroid injection (p<0.05). Postprandial glucose level until was significantly higher than the preoperative level up to 8 days after surgery (p<0.05). In 5 of 25 patients, insulin dosage had to be increased to control plasma glucose level. The Hb A1c level in patients with insulin dosage augmentation (9.3Å}1.1%) was significantly higher than that of the remaining cases (7.3Å}1.5%, p<0.05). Conclusions: Intravitreal and posterior sub–Tenon injection of triamcinolone for diabetic macular edema significantly increases the plasma glucose concentration, especially the postprandial glucose level. The plasma glucose level should be carefully observed after triamcinolone injection.
Keywords: diabetic retinopathy • macula/fovea