Intravitreal Injection of Triamcinolone for Refractory Diabetic Macular Edema

Kim, In Cheol; Cho, Nam Chun; Ahn, Min

Abstract

PURPOSE
To determine the efficacy and safety of intravitreal triamcinolone acetonide given to treat diabetic macular edema that was unresponsive to a prior laser photocoagulation. METHODS: An intravitreal injection of 4 mg triamcinolone acetonide was given to 25 eyes with a clinically significant diabetic macular edema (CSME) that failed to respond to conventional treatment within an average of 7.56 months after laser photocoagulation. There were 13 females and 4 bilateral cases. The mean age was 60.4 +/- 6.9 years. The response to treatment was monitored functionally by a visual acuity assessment and anatomically by an OCT macular thickness at 1-, 2-, and 6-month intervals after the injection. RESULTS: After the intravitreal injection of triamcinolone acetonide, 18 out of 25 eyes (72%), 20 out of 25 eyes (80%), and 13 out of 18 eyes (72%) showed improvement of the mean visual acuity at the 1-, 2-, and 6-month follow-up intervals. The central macular thickness as measured by the OCT decreased by 43%, 45%, and 20%, respectively, over these same intervals from an initial pretreatment mean of 498.7 +/- 131.6 micro meter. The postoperative complications were an intraocular pressure elevation (3 eyes), and cataract (3 eyes). However, there were no serious postoperative complications such as retinal detachment, vitreous hemorrhage and endophthalmitis. CONCLUSIONS: An intravitreal injection of triamcinolone acetonide may be useful for treating a diabetic macular edema that is resistant to conventional laser photocoagulation.