Diffuse diabetic macular edema: results after intravitreal triamcinolone acetonide

Abstract

Purpose: To evaluate the clinical outcome of an intravitreal injection of triamcinolone acetonide as treatment of diffuse diabetic macular edema.

Materials and methods: The prospective, interventional, clinical case series study included 20 patients (26 eyes) who received an intravitreal injection of 20 mg to 25 mg of triamcinolone acetonide as treatment of diffuse diabetic macular edema. The injection was done under topical anesthesia and sterile conditions in the operating room. Mean follow-up ranged at 6.64 ± 6.10 months. The study group was compared with a control group of 16 patients who underwent macular grid laser coagulations.

Results: In the study group, visual acuity increased significantly (p< 0.001) from 0.12 ± 0.08 at baseline to a maximum of 0.19 ± 0.14 during the follow-up. Seventeen (81%) of 21 eyes with a follow-up of more than 1 month gained in visual acuity. In the control group, visual acuity did not change significantly. In the study group, intraocular pressure increased significantly (p< 0.001) from 16.9 ± 2.5 mm Hg to a mean maximal value of 21.3 ± 4.7 mm Hg, and decreased significantly (p = 0.028) to 17.7 ± 4.7 mm Hg at the end of the study. This occurred parallel to the disappearance of the crystals in the vitreous. Intraocular pressure could be controlled with topical antiglaucomatous drops.

Conclusion: Intravitreal injection of 20 mg to 25 mg triamcinolone acetonide might increase visual acuity in patients with clinically significant diffuse diabetic macular edema.

Read at the 2^nd International Conference on Vitreoretinal Diseases in Vienna/Austria, September 8, 2002.