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SJ Bakri, PM Beer; Intravitreal Triamcinolone for Diabetic Macular Edema: A Clinical andFluorescein Angiographic Study . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3458.
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Purpose: To report the outcome of treatment of persistent diabetic macular edema with an intravitreal injection of triamcinolone acetonide. Methods: Retrospective interventional non-comparative case series. Nineteen eyes of 16 patients with diabetic macular edema persistent after focal or grid laser photocoagulation received a single 4mg intravitreal triamcinolone injection. Outcome measures were Snellen visual acuity, Goldmann intraocular pressure and fluorescein angiography. Results: Four eyes (21.1%) showed a marked improvement, 10 (52.6%) showed a mild improvement, and 5 (26.3%) showed no change of macular edema on fluorescein angiography. No patients had worsening of their macular edema. Visual acuity improved by 1 or more lines in 13 eyes (68.4%), by 2 or more lines in 5 eyes (26.3%), by 3 or more lines in 2 eyes (10.5%) and by 4 lines in 1 eye (5.3%). Acuity remained unchanged in 5 eyes (26.3%), and deteriorated by 1 line in 1 eye. An intraocular pressure elevation of 10mmHg or greater occurred in 2 eyes (10.5%), and was successfully treated by topical medication. The triamcinolone was well-tolerated and there were no other ocular complications. Conclusion: Intravitreal triamcinolone resulted in angiographic improvement of macular edema in 74% of 19 eyes, with visual improvement in 68.4%, and was well-tolerated. A significant intraocular pressure rise occurring in 10.5% of eyes responded to topical medication in all cases. Intravitreal triamcinolone has potential as a new modality in the treatment of diabetic macular edema, and would be worth investigating in a randomized prospective clinical trial. View OriginalDownload SlideView OriginalDownload Slide
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