Intravitreal triamcinolone acetonide for diabetic macular edema

Janet J. Chieh, Daniel B. Roth, Mimi Liu, Jonathan Belmont, Mark Nelson, Carl Regillo, Adam Martidis

Research output: Contribution to journalReview articlepeer-review

69 Scopus citations

Abstract

Purpose: Intravitreal injection of triamcinolone acetonide has been advocated to treat exudative diabetic macular edema. The purpose of the study was to evaluate the clinical outcome of an intravitreal injection of triamcinolone acetonide as treatment for diffuse diabetic macular edema. Methods: This study was a retrospective, interventional, clinical case series examining 210 eyes of 174 patients who received an intravitreal injection of 1 or 4 mg of triamcinolone acetonide for treatment of diffuse diabetic macular edema. Inclusion criteria were clinically significant macular edema, visual acuity loss, and leakage shown by flgorescein angiography. Main outcome measures were visual acuity and intraocular pressure. Mean follow-up time ± SD was 6.6 ± 3.1 months. Results: In the study group, visual acuity improved significantly (P < 0.001) from a median of 20/200 (mean logMAR, 0.92) at baseline to 20/80 (mean logMAR, 0.82) at 6 months. Mean intraocular pressure ± SD increased from 15.4 ± 3.4 mmHg (median, 16 mmHg; range, 6-26 mmHg) to a maximal value of 20.4 ± 6.2 mmHg (median, 19 mmHg; range, 12-51 mmHg) during the follow-up period. Complications included culture-negative sterile endophthalmitis in six cases and cataract extraction in five eyes. Conclusions: Intravitreal injection of 1 to 4 mg of triamcinolone acetonide may benefit patients by improving visual acuity in eyes with clinically significant diabetic macular edema. This study did not provide significant evidence to justify its routine use in clinical practice for all patients with diabetic macular edema. A randomized clinical trial on this issue would provide more conclusive evidence and help identify those patients most likely to benefit from intravitreal triamcinolone acetonide.

Original languageEnglish
Pages (from-to)828-834
Number of pages7
JournalRetina
Volume25
Issue number7
DOIs
StatePublished - Oct 2005
Externally publishedYes

Keywords

  • Clinically significant macular edema
  • Diabetic macular edema
  • Diabetic retinopathy
  • Intravitreal triamcinolone acetonide
  • Laser photocoagulation
  • Vascular permeability

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