Figen Batioglu, MD, Emin Ozmert, MD, Department of Ophthalmology, Ankara University, Ankara, Turkey

Purpose:

To evaluate the efficacy and safety of intravitreal triamcinolone acetonide for diabetic macular edema.

Methods:

Twenty-six eyes of 20 diabetic patients with macular edema that failed to respond to previous laser photocoagulation were included in the study. After a complete ophthalmic examination, central macular thickness measurements were taken from optical coherence tomography (OCT) scans. Twenty-three eyes were offered intravitreal injection of 4mg (0.1 ml) triamcinolone acetonide as a primary procedure and the remaining three received the injection at the end of vitreoretinal surgery. During the follow-up, visual acuity, quantitative change in OCT macular thickening were assessed and potential complications were monitored. Statistical analysis was performed in eyes which had a followup of at least 3 months.

Results:

The mean follow-up period was 4.6 months (range: 1- 14 months). Baseline central macular thickness averaged 828.13 micron. At the third day, a reduction in the mean central macular thickness of 36.6% from 828.13 micron to 524.8 micron was obtained.
At 1 and 3 months, macular thickness measurements decreased by 58% (347.73 micron), and 48.7% (425.2 micron) respectively. The mean central macular thickness which was obtained at 3 Р15 days, 1 and 3 months was significantly different than the baseline measurement. During the follow-up, five (19.2%) patients developed intraocular pressure values higher than 21mmHg, which could be controlled by topical antiglaucomatous treatment. Four (15%) patients required retreatment of intravitreal injections.

Conclusion:

Optical coherence tomography demonstrated significant anatomic improvement in the majority of patients with diabetic macular edema treated with intravitreal injection of triamcinolone acetonide in the short-term.

Take-home message:

Although short-term results are encouraging, further studies are necessary to assess the long-term efficacy and safety, and the need for retreatment of intravitreal triamcinole injections.