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A. Ladjimi, S. Zaouali, S. Jenzeri, R. Messaoud, H. Mzali, M. Khairallah; Primary intravitreal triamcinolone acetonide for severe diabetic hard exudates: a clinical and fluorescein angiographic study . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4068.
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Purpose: To analyze the clinical and angiographic outcomes of diabetic macular edema with severe hard exudates treated with intravitreal triamcinolone acetonide (TA). Methods: The study included 12 eyes of 12 patients with severe diabetic macular hard exudates, who received an intravitreal injection of 4 mg of TA. Mean + SD age was 58.07 + 10.28 years. Evaluation before injection and throughout follow–up included Snellen visual acuity, slit–lamp examination, fundus photography, and fluorescein angiography. Follow–up period ranged from 3 to 12 months (mean, 6.27 months). Results: Mean visual acuity improved significantly from 20/300 to 20/160 (p = 0.039). Hard exudates resolved completely in 4 eyes (33%) and partially in 8 eyes (66%). Fluorescein leakage decreased significantly in 11 eyes (91.7%). A decrease in microaneurysms number was observed in all cases. An intraocular pressure elevation occurred in 3 eyes (25%), and was successfully treated by topical medication. No other complications, such as endophthalmitis or pseudo–endophthalmitis were recorded. Conclusions: Intravitreal injection of TA appears to be beneficial for reducing hard exudates, decreasing fluorescein leakage, reducing the number of microaneurysms and improving significantly visual acuity in patients with severe diabetic hard exudates. Further studies with a larger number of patients are required to assess the long–term efficacy and safety, and the need for retreatment.
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