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Advantages:

Intravitreal triamcinolone injections turned out to be effective in reducing macular edema and improving vision in refractory DME after a laser treatment or even as an initial treatment. The steroid-related adverse events, e.g. cataract and elevated intraocular pressure, should be weighed against the benefits of the treatment.

Methods:

Twenty-mg triamcinolone acetonide intravitreal injections (IVTA) were applied to 110 DME patients after ineffective laserphotocoagulation or as a initial treatment. BCVA for distant and near vision, central retinal thickness and intraocular pressure (IOP) were analyzed before and after the treatment at 1 week and 1, 3, 6 month intervals. The measurements were continued in cases of repeated IVTA.

Effectiveness / Safety:

We observed a statistically significant improvement in BCVA in near and distant vision and a decrease in central retinal thickness after all time-intervals after IVTA in the observed group. BCVA to distant vision was not statistically significantly better after repeated IVTA. IOP increase was observed at 1 week and 1,3 months after IVTA, but not at 6 months after IVTA. No sight-threatening side effects of IVTA were observed.

Take home message:

IVTA is useful in stabilizing DME progression, although its therapeutic effect can be time-limited.