Purchase this article with an account.
A.P. Ciardella, W. Schiff, G. Barile, K. Langton, S. Chang; Intravitreal Triamcinolone for the Treatment of Refractory Diabetic Macular Edema: An Optical Coherence Tomography Study . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3218.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To investigate the use of intravitreal injection of triamcinolone acetonide (TA) for the treatment of refractory diabetic macular edema unresponsive to prior laser photocoagulation. Methods: Retrospective chart review of eyes with refractory diabetic macular edema treated with intravitreal injection of TA. Eyes diagnosed with persistent clinically significant diabetic macular edema (CSME) which had failed to respond to at least 2 previous sessions of laser photocoagulation according to the Early Treatment Diabetic Retinopathy Study (ETDRS) guidelines were considered for the study. At least 6 months after initial laser therapy, the macular thickness was measured by optical coherence tomography (OCT). Eyes with a residual central macular thickness greater than 300 microns and visual loss were offered intravitreal injection of 4 mg of TA. The visual and anatomic responses were observed. An OCT examination was performed at each follw-up visit.Complications related to the injection procedure and corticosteroid medication were recorded. Results: Twenty four eyes of 18 patients completed 6 or more months of follow-up and were included in the study. The mean age of the patients was 62 years, There were 11 males and 7 females. The mean Snellen visual acuity improved from 20/200 to 20/80 at the 6 month follow-up visit. The mean central macular thicknes improved from 530 microns to 257 microns at the 6 month follow-up. Eight of 24 eyes had more than one intravitreal injection of TA, because of recurrence of macular edema. Intraocular pressure exceeded 21 mm Hg in 8 of 24 eyes during the 6 months follow-up. No other complications were noted. Conclusions: Intravitreal TA is a promising treatment for refractory diabetic macular edema. OCT aids in the mangement of these cases. Further study is warranted to assess the long-term efficacy and safety of this therapy.
This PDF is available to Subscribers Only