J Korean Ophthalmol Soc.  2009 Jun;50(6):864-869. 10.3341/jkos.2009.50.6.864.

The Effect of Posterior Subtenon Triamcinolone Injection in Panretinal Photocoagulation Induced Visual Dysfunction of Diabetic Retinopathy

• Hwang HB
• Park YH

• KMID: 2212363
• DOI: http://doi.org/10.3341/jkos.2009.50.6.864

Abstract

PURPOSE: To evaluate the efficacy of a prophylactic posterior sub-Tenon's capsule injection of Triamcinolone acetonide (TA) against macular edema and visual dysfunction by panretinal photocoagulation (PRP) in patients with severe nonproliferative and proliferative diabetic retinopathy.
METHODS
Thirty-eight eyes of 19 patients who have diabetic retinopathy without macular edema and whose retinopathy was bilateral and symmetrical were evaluated. Triamcinolone was injected into the posterior sub-Tenon's capsule in one eye of the patients and nothing was injected in the other eye as a control. Two weeks later, PRP was performed every other week for 4 sessions on both eyes in all patients. The clinical course of visual acuity and macular edema was monitored for up to approximately 6 months after the initial PRP.
RESULTS
There was no statistically significant difference of visual acuity before PRP in the 2 groups (p>0.05), and there was no macular edema in any patient. For a follow-up period of 6 months, visual dysfunction was more severe in the TA-injected eye than the control. However, the difference was not statistically significant (p>0.05) throughout the follow-up period except at the 20-week time point. On the other hand, macular edema occurred in 2 eyes (10.5%) of the TA-injected group, and in 4 eyes (21.1%) of the control group. IOP elevation as a complication caused by TA-injection occurred in 2 eyes (10.5%). However, IOP was controlled successfully by anti-glaucomatic eye drops.
CONCLUSIONS
Posterior sub-Tenon's capsule injection of Triamcinolone is a safe and effective treatment modality for preventing PRP-induced visual dysfunction and macular edema.

Keyword

Panretinal photocoagulation; Posterior sub-Tenon's capsule injection of Triamcinolone acetonide

MeSH Terms

Diabetic Retinopathy
Eye
Follow-Up Studies
Hand
Humans
Light Coagulation
Macular Edema
Ophthalmic Solutions
Triamcinolone
Triamcinolone Acetonide
Visual Acuity
Ophthalmic Solutions
Triamcinolone
Triamcinolone Acetonide

Figure

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  Figure 1. Line graph illustrating of the clinical course of logarithm of the minimum angle of resolution (logMAR) visual acuity between the TA-inejcted and control eyes. There was not statistically significant difference between two groups before TA injection and after 2 weeks. TA-injected group shows relatively good vision than control group through the follow-up period. But the difference was not statistically significant (p>0.05) except at 20 weeks follow-up time point (p<0.05). (* statistically significant difference between the TA-injected and control eyes at the point)

Reference

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