Remzi Avci, Berkant Kaderli

Purpose:

To determine the efficacy and safety of intravitreal triamcinolone injection in chronic diabetic macular edema with severe foveal hard exudates.

Methods:

This prospective, interventional consecutive case series preliminary study consisted of 17 eyes (14 patients) with chronic diabetic macular edema and severe foveal hard exudates which received an intravitreal injection of 4mg triamcinolone acetonide. The results were evaluated by clinical examination and fluorescein angiography. Potential complications such as intraocular pressure rise, cataract progression and endophthalmitis were recorded.

Results:

All patients completed 6 months (mean 7.8┬▒3.4 months) follow-up. In all eyes the hard exudates were resolved (53%) or decreased (47%), and 2 or more lines visual acuity improvement was achieved in 5 eyes (29%) during the follow-up period. Intraocular pressure exceeded 21mmHg in 3 eyes, which were controlled by topical medication. One eye exhibited signs of cataract progression. Endophthalmitis or pseudoendophthalmitis were not observed in any of the eyes.

Conclusion:

Intravitreal injection of 4mg triamcinolone acetonide appears to be a safe and effective therapeutic method for the resolution of severe foveal hard exudates in chronic diabetic macular edema in this study. Although this is not always associated with visual acuity improvement, it may be considered as a less invasive treatment modality than surgical removal of hard exudates. Further studies would enable the assesment of the universal effectiveness of this treatment.