Eylem Yaman, MD, Mehmet Cakır, Ziya Kapran, MD, Irfan Perente, MD, Yaprak Banu Unver, MD, Nur Acar, MD, Tugrul Altan, MD, Zerrin Bayraktar, MD, Muhammet Beyazal, MD

Purpose:

To determine the efficacy of intravitreal triamcinolone acetonide on diabetic macular edema (ME) by optical coherence tomography (OCT).

Methods:

In this prospective study performed in Beyoglu Eye Education and Research Hospital between January and March 2004, 16 eyes of 15 patients with diabetic macular edema having central macular thickness (CMT) of equal or more than 300 microns were included.
Diabetic macular edema was classified into 3 groups as diffuse ME, cystoid ME and ME with sensorial retinal detachment according to OCT. 4 mg/0.1cc triamcinolone acetonide was injected intravitreally. Central macular thickness (CMT) was calculated by OCT before and after 1st, 2nd and 4th weeks of the injection. Best corrected visual acuities (BCVA) according to Snellen chart and intraocular pressures (IOP) by applanation tonometry were recorded.

Results:

The study included 15 patients (8 female, 7 male) with a mean age of 63.18 + 6.53 years. Mean preinjection CMT of 437.50 + 90.65µ decreased to a mean of 330.38 + 97.50µ, 290.20 + 90.40µ and 301.83 + 114.34µ at the 1st, 2nd and 4th weeks respectively.
Preinjection mean BCVA of 0.18 + 0.14 increased to a mean of 0.23 + 0.19 at first month. The decrease in CMT and increase in BCVA was most prominent in the diffuse ME group. In only 1 eye, increased IOP was controlled by topical antiglaucomatous agent. No endophthalmitis due to the procedure was encountered.

Conclusion:

Intravitreal triamcinolone acetonide is effective on decreasing diabetic ME. This decrease in CMT is found to be especially remarkable at the first week after injection which is quantitatively detected by OCT. The decrease in CMT was accompanied by increase in BCVA mostly in the diffuse ME group.

Take-home message:

Intravitreal triamcinolone acetonide is effective on decreasing diabetic macular edema, especially in the diffuse ME group. By OCT the decrease in CMT can be demonstrated objectively.