http://www.evrs.eu/medias/2005/congress/Intravitreal-Triamcinolone-(IVT)-for-Diabetic-Massive-Macular-Hard-Exudates.swf

S. Ben Yahia , B. Jelliti, K. Hmidi, F. Amouri, S. Attia, R. Messaoud, A. Ladjimi, M. Khairallah

Purpose:

To evaluate the efficacy of intravitreal triamcinolone acetonide (TA) as treatment for massive macular hard exudates in diabetic patients.

Methods:

Prospective, noncomparative, interventional case series, of twelve eyes (12 patients) with massive hard exudates involving the fovea that had no previous focal laser treatment. A single intravitreal injection of 4 mg TA in 0.1 ml was performed.

Results:

Follow-up period ranged from 6 to 18 months (mean: 10 months). Visual acuity improved significantly at examinations performed 1 month (p = 0.008), 3 months (p = 0.008) and 6 months (p = 0.003) after the injection. Foveal hard exudates resolved completely in 6 eyes (50%) and partially in 6 eyes (50%). Fluorescein leakage decreased and a variable proportion of microaneurysms disappeared in all cases. An intraocular pressure elevation occurred in 3 eyes (25%), and was successfully treated by topical medication. No other complications, such as endophthalmitis, were recorded.

Conclusion:

Intravitreal injection of TA appears to be beneficial for reducing hard exudates, decreasing fluorescein leakage, and improving significantly visual acuity in patients with diabetic massive hard exudates.

Take-home message:

Intravitreal triamcinolone is a simple, interesting treatment for diabetic massive macular hard exudates which should be more investigated.