Abstract
Abstract: :
Purpose: To study the effect of sub–Tenonís triamcinolone acetonide (TA) as a treatment for refractory diabetic macular edema (DME). Method: Prospective monocentric pilot study of patients who had received a posterior sub–Tenonís injection of 40mg TA as a treatment of DME. 18 eyes of 17 patients (10 women and 7 men, aged 38 – 73 years) were treated. In all eyes, panretinal photocoaguration and focal photocoagulation for DME had been performed. 11 eyes had undergone vitrectomy (5 eyes for proliferative diabetic retinopathy, 6 eyes for DME). All eyes were examined before and throughout follow–up with visual acuity, anterior chamber laser flare cell meter, fluorescein angiography (FA), and optical coherence topography (OCT). Results: Mean follow–up time was 4.1 months (range 3– 5months). In 13 eyes (72.2 %), central retinal thickness had reduced significantly as measured by OCT. At the same time, the breakdown of blood–ocular barrier was improved as observed laser flare cell meter and FA . However the edema recurred in 5 eyes (27.8%), 2 to 4 months after TA injection. Visual acuity improved in 4 eyes (22.2%), remained in 14 eyes (77.8%), and reduced in no eyes. Intraocular pressure elevation more than 21 mmHg was observed transiently in one eye (5.6%). No other complications were not observed. Conclusion: Posterior sub–Tenonís injection of TA may be useful for improvement of diabetic macular edema, however the recurrence sometimes occur.
Keywords: diabetic retinopathy • macula/fovea • corticosteroids