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Two-year results of intravitreal triamcinolone acetonide injection for the treatment of diabetic macular edema

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Abstract

Purpose

To investigate 2-year results of intravitreal triamcinolone acetonide injection for the treatment of diffuse diabetic macular edema unresponsive to previous laser photocoagulation.

Method

The study included 75 eyes of 75 diabetic patients with clinically significant diffuse macular edema that had failed to respond to previous laser photocoagulation. An intravitreal injection of triamcinolone acetonide at the dose of 4 mg/0.1 ml was administered. Best-corrected visual acuity was measured as the logarithm of the minimum angle of resolution (logMAR), and central macular thickness was obtained by optical coherence tomography at each visit. Intraocular pressure and lenticular status were also evaluated. Differences among measurements were evaluated by Friedman two-way analysis of variance by ranks. Mean follow-up period was 24.7 ± 5.9 months.

Results

The mean central macular thickness, which was obtained 3 days, 1 month, 3 months, 6 months, 9 months, 12 months, 18 months and 24 months postoperatively, was significantly different from the baseline measurement (P < 0.001). Mean best-corrected logMAR visual acuity improved significantly from baseline at the 1- month and 3-month follow-up intervals (P < 0.05), but there was no significant change at the 6- month, 9-month, 12-month, 18-month or 24-month follow-up periods (P > 0.05). During the follow-up, 29 (38.7%) eyes received re-injection of intravitreal triamcinolone. Twenty-one (28%) eyes developed intraocular pressure values higher than 21 mmHg, and 18 (24%) eyes developed cataract. Thirteen (17.3%) eyes required cataract and/or glaucoma surgery.

Conclusions

In refractory diabetic macular edema, intravitreal triamcinolone effectively reduces foveal thickness and improves visual acuity in the short term, but with the extended follow-up, the number of recurrences and steroid-related complications were shown to increase. Nevertheless, it may be a therapeutic option in some patients that do not respond to previous laser photocoagulation.

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References

  1. Ferris FL, Patz A (1984) Macular edema. A complication of diabetic retinopathy. Surv Ophthalmol 28:452–461

    Article  PubMed  Google Scholar 

  2. Early Treatment Diabetic Retinopathy Study Research Group (1985) Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Arch Ophthalmol 103:1796–1806

    Google Scholar 

  3. Lee CM, Olk RJ (1991) Modified grid laser photocoagulation for diffuse diabetic macular edema: long-term visual results. Ophthalmology 98:1594–1602

    PubMed  CAS  Google Scholar 

  4. Martidis A, Duker JS, Greenberg PB, et al (2002) Intravitreal triamcinolone for refractory diabetic macular edema. Ophthalmology 109(5):920–927

    Article  PubMed  Google Scholar 

  5. Ip MS, Kumar KS (2002) Intravitreous triamcinolone acetonide as a treatment for macular edema from central retinal vein occlusion. Arch Ophthalmol 120:1217–1219

    PubMed  Google Scholar 

  6. Antcliff RJ, Spalton DJ, Stanford MR, et al (2001) Intravitreal triamcinolone for uveitic cystoid macular edema: an optical coherence tomography study. Ophthalmology 108:765–772

    Article  PubMed  CAS  Google Scholar 

  7. Benhamou B, Massin P., Haouchine B, et al (2003) Intravitreal triamcinolone for refractory pseudophakic macular edema. Am J Ophthalmol 135:246–249

    Article  PubMed  Google Scholar 

  8. Tano Y, Chandler D, Machemer R (1980) Treatment of intraocular proliferation with intravitreal injection of triamcinolone acetonide. Am J Ophthalmol 90:810–816

    PubMed  CAS  Google Scholar 

  9. Danis RP, Bingaman DP, Yang Y, Ladd B (1996) Inhibition of preretinal and optic nerve head neovascularization in pigs by intravitreal triamcinolone acetonide. Ophthalmology 103:2099–2104

    PubMed  CAS  Google Scholar 

  10. Danis RP, Ciulla TA, Pratt LM, Anliker W (2000) Intravitreal triamcinolone acetonide in exudative age-related macular degeneration. Retina 20:244–250

    Article  PubMed  CAS  Google Scholar 

  11. Massin P, Audren F, Haouchine B, et al (2004) Intravitreal triamcinolone acetonide for diabetic diffuse macular edema. Preliminary results of a prospective controlled trial. Ophthalmology 111:218–225

    Article  PubMed  Google Scholar 

  12. Blodi BA, Paluska SA (1997) Cataract after vitrectomy in young patients. Ophthalmology 104:1092–1095

    PubMed  CAS  Google Scholar 

  13. Sidney S, Castellan J (1988) Nonparametric statistics for the behavioral sciences. McGraw-Hill, New York, pp 174–183, chapt 7

    Google Scholar 

  14. Graham RO, Peyman GA (1974) Intravitreal injection of dexamethasone: treatment of experimentally induced endophthalmitis. Arch Ophthalmol 92:149–154

    PubMed  CAS  Google Scholar 

  15. Wilson CA, Berkowitz BA, Sato Y, et al (1992) Treatment with intravitreal steroid reduces blood–retinal barrier breakdown due to retinal photocoagulation. Arch Ophthalmol 110:1155–1159

    PubMed  CAS  Google Scholar 

  16. Bresnick GH (1986) Diabetic macular edema: a review. Ophthalmology 93:989–997

    PubMed  CAS  Google Scholar 

  17. Jonas JB, Kreissig I, Sofker A, Degenring RF (2003) Intravitreal injection of triamcinolone for diffuse diabetic macular edema. Arch Ophthalmol 121:57–61

    Article  PubMed  CAS  Google Scholar 

  18. Larsson J, Zhu M, Sutter F, Gillies MC (2005) Relation between reduction of foveal thickness and visual acuity in diabetic macular edema treated with intravitreal triamcinolone. Am J Ophthalmol 139:802–806

    Article  PubMed  Google Scholar 

  19. Jonas JB, Kreissig I, Degenring RF (2003) Intraocular pressure after intravitreal injection of triamcinolone acetonide. Br J Ophthalmol 87:24–27

    Article  PubMed  CAS  Google Scholar 

  20. Jonas JB, Degengring RF, Kamppeter BA, Kreissig I, Akkoyun İ (2004) Duration of the effect of intravitreal triamcinolone acetonide as treatment of diffuse diabetic macular edema. Am J Ophthalmol 138:158–160

    Article  PubMed  CAS  Google Scholar 

  21. Bucala R, Gallati M, Manabe S, Cother E, Cerami A (1985) Glucocorticoid-lens protein adducts in experimentally induced steroid cataracts. Exp Eye Res 40:853–863

    Article  PubMed  CAS  Google Scholar 

  22. Danis RP, Ciulla TA, Pratt LM, Anliker W (2000) Intravitreal triamcinolone acetonide in exudative age-related macular degeneration. Retina 20:244–250

    Article  PubMed  CAS  Google Scholar 

  23. Gillies MC, Simpson JM, Billson TA et al (2004) Safety of an intravitreal injection of triamcinolone. Results from a randomized clinical trial. Arch Ophthalmol 133:336–340

    Article  Google Scholar 

  24. Çekiç O, Chang S, Tseng JJ et al (2005) Cataract progression after intravitreal triamcinolone injection. Am J Ophthalmol 139:993–998

    Article  PubMed  Google Scholar 

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Acknowledgment

The authors are thankful to Dr. Atilla Elhan for the statistical analysis.

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Authors and Affiliations

  1. Department of Ophthalmology, Faculty of Medicine, Ankara University, Mamak Street, Ankara, 06100, Turkey

    Figen Batıoğlu, Emin Özmert, Neslihan Parmak & Selcen Çelik

  2. Meriç sokak No. 30, Angora Evleri Beysukent, Ankara, Turkey

    Figen Batıoğlu

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  1. Figen Batıoğlu
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  2. Emin Özmert
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  4. Selcen Çelik
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Correspondence to Figen Batıoğlu.

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Batıoğlu, F., Özmert, E., Parmak, N. et al. Two-year results of intravitreal triamcinolone acetonide injection for the treatment of diabetic macular edema. Int Ophthalmol 27, 299–306 (2007). https://doi.org/10.1007/s10792-007-9072-7

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  • DOI: https://doi.org/10.1007/s10792-007-9072-7

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