May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Primary Intravitreal Triamcinolone Acetonide Combined with Grid Laser Photocoagulation for Diffuse Diabetic Macular Edema: Optical Coherence Tomography (OCT) Assessment
Author Affiliations & Notes
  • C.F. Fernandez
    Retina & Vitreous Service, Clinica Oftal Ctro Caracas, Caracas, Venezuela
  • A.J. Mendoza
    Retina & Vitreous Service, Clinica Oftal Ctro Caracas, Caracas, Venezuela
  • J.F. Arevalo
    Retina & Vitreous Service, Clinica Oftal Ctro Caracas, Caracas, Venezuela
  • Footnotes
    Commercial Relationships  C.F. Fernandez, None; A.J. Mendoza, None; J.F. Arevalo, None.
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 1936. doi:
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      C.F. Fernandez, A.J. Mendoza, J.F. Arevalo; Primary Intravitreal Triamcinolone Acetonide Combined with Grid Laser Photocoagulation for Diffuse Diabetic Macular Edema: Optical Coherence Tomography (OCT) Assessment . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1936.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose:To determine if primary intravitreal injection of triamcinolone acetonide (TA) plus grid laser photocoagulation (GLP) is effective in treating diffuse diabetic macular edema. Methods:Thirty eyes (18 patients) with clinically significant diffuse diabetic macular edema (CSDME) participated in this retrospective non–randomized controlled case series. Fourteen eyes (10 patients) diagnosed with CSDME were treated with GLF according to the Early Treatment Diabetic Retinopathy Study (ETDRS) guidelines plus an intravitreal injection of 4 mg of TA (Study Group). A control group was included (16 eyes [8 patients]) treated with GLP only. The response to treatment was measured by clinical examination, fluorescein angiography (FA), and optical coherence tomography (OCT). The visual, and anatomic responses were observed as well as complications related to the injection procedure and corticosteroid administration. Visual acuity (VA), and quantitative change in OCT macular thickness were assessed. Potential complications were monitored, including intraocular pressure (IOP) response, cataract progression, retinal detachment, vitreous hemorrhage, and endophthalmitis. Results:The mean follow up in our study group was 4.93 months (1 to 11 months). Mean variability in VA in the study group was –0.5 ETDRS lines (range: –6 to +5 lines). In three (21.43%) eyes VA increased > 2 ETDRS lines, in five (35.71%) eyes VA remained the same, and VA decreased >2 ETDRS lines in six (42.86%) eyes. Central macular thickness as measured by OCT decreased a mean of 83.79 µm (22.22%). Four eyes developed an increased in intraocular pressure in our study group. Mean variability in VA in the control group was 0.5 ETDRS lines (range: –8 to +10 lines). In 4 (25%) eyes VA increased, in 11 (68.7%) eyes VA remained the same, and decreased in 1 (6.25%) eye. This difference was not statistically significant (p = 0.2). Four (28.57%) eyes developed an increased in intraocular pressure in our study group. However, it was medically controlled with topical anti–glaucoma medication. Conclusions:Although 100% of our patients improved CSDME by means of OCT and FA, 42.86% lost two or more lines in VA with primary intravitreal injection of TA plus GLP. We believed that other factors might play a role in VA loss. Primary intravitreal injection of TA plus GLP may not be as efficacious as expected.

Keywords: diabetes • corticosteroids • macula/fovea 
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