Intravitreal triamcinolone as a primary therapy in diabetic macular oedema

Abstract

Purpose: To evaluate the effect of intravitreal triamcinolone in eyes with diabetic macular oedema that had no previous laser treatment.

Methods: In all, 12 eyes of 12 patients with diabetic retinopathy, aged 47-70 years (mean 59.2), made up the study. All the eyes had persistent diabetic macular oedema despite having received medical treatment for at least 3 months. In this consecutive case series, none of the eyes received previous laser photocoagulation. Intravitreal injection of 0.1 ml (4 mg) triamcinolone acetonide was offered to treat macular oedema. The visual and anatomic responses were observed as well as complications related to the injection procedure and corticosteroid medication.

Results: The follow-up period was between 6 and 10 months (mean 7.9 months) and all eyes completed 6 months of follow-up. Macular oedema was documented for an average of 3.5 months (ranged 3-5 months) before intravitreal corticosteroid injection. Baseline mean central macular thickness was 448.6 microm. At 1 month follow-up, a reduction in mean central macular thickness of 40.8% from 448.6 microm to 265.4 microm was obtained. At 3 and 6 months follow-up, mean central macular thicknesses, were 310 mum and 294.5 mum, respectively. No eyes lost vision at 1 month and 10 eyes (83.2%) showed improvement. At 3 months, no eyes lost vision from baseline and 8 eyes (66.6%) showed improvement. At 6 months, again no eyes lost vision from baseline and 10 eyes (83.2%) maintained improved visual acuity.

Conclusions: Intravitreal triamcinolone is a promising therapeutic method in eyes with diabetic macular oedema without previous application of laser treatment. Further study with longer follow-up and large series is warranted to assess the long-term efficacy and safety and the need for retreatment.