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Clinical Trial
. 2005 Mar;89(3):321-6.
doi: 10.1136/bjo.2004.046391.

Diffuse diabetic macular oedema treated by intravitreal triamcinolone acetonide: a comparative, non-randomised study

J B Jonas  1 , I Akkoyun, I Kreissig, R F Degenring
Affiliations
Clinical Trial

Diffuse diabetic macular oedema treated by intravitreal triamcinolone acetonide: a comparative, non-randomised study

J B Jonas et al. Br J Ophthalmol. 2005 Mar.

Abstract

Aim: To report on visual outcome of patients receiving an intravitreal injection of triamcinolone acetonide for treatment of diffuse diabetic macular oedema.

Methods: Prospective, comparative, non-randomised clinical interventional study included 136 patients with diffuse diabetic macular oedema. Patients of the study group (97 eyes) received an intravitreal injection of 20-25 mg of triamcinolone acetonide and no other retinal treatment. Patients of the control group (69 eyes) received focal or panretinal laser treatment if indicated. Mean (standard deviation) follow up was 8.4 (SD 6.0) months (range 1.03-25.2 months).

Results: Visual acuity (VA) increased significantly (p<0.001) in the study group with 66 (68%) eyes gaining in VA by at least two Snellen lines. In the control group, VA did not change significantly during the first 4 months of follow up, and decreased significantly (p<0.001) towards the end of the follow up. Difference in change of best VA was significant (p<0.001) between both groups. Correspondingly, the number of patients with VA improvement of two or more Snellen lines and visual loss of two or more Snellen lines, respectively, was significantly (p<0.001) higher and lower, respectively, in the study group.

Conclusions: Intravitreal triamcinolone acetonide can temporarily increase VA in some patients with diffuse diabetic macular oedema.

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Figures

Figure 1
Figure 1
Histogram showing the distribution of change in best visual acuity during follow up.
Figure 2
Figure 2
Diagram showing change in visual acuity (expressed in Snellen lines) in the study group and control group during follow up.
Figure 3
Figure 3
Fluorescein angiography and optical coherence tomography before, and 11 weeks after, intravitreal injection of triamcinolone acetonide. Note: decrease in fluorescein leakage and decrease in retinal thickening parallel to an increase in visual acuity from 0.20 to 0.40. (A and B) fluorescein angiograms; (C and D) optical coherent tomograms.
See this image and copyright information in PMC

References

    1. Jonas JB, Hayler JK, Söfker A, et al. Intravitreal injection of crystalline cortisone as adjunctive treatment of proliferative diabetic retinopathy. Am J Ophthalmol 2001;131:468–71. - PubMed
    1. Jonas JB, Söfker A. Intraocular injection of crystalline cortisone as adjunctive treatment of diabetic macular edema. Am J Ophthalmol 2001;132:425–7. - PubMed
    1. Martidis A, Duker JS, Greenberg PB, et al. Intravitreal triamcinolone for refractory diabetic macular edema. Ophthalmology 2002;109:920–7. - PubMed
    1. Jonas JB, Kreissig I, Söfker A, et al. Intravitreal injection of triamcinolone acetonide for diabetic macular edema. Arch Ophthalmol 2003;121:57–61. - PubMed
    1. Early Treatment Diabetic Retinopathy Study Research Group. Retinopathy study design and baseline patient characteristics: ETDRS report number 7. Ophthalmology 1991;98:741–56. - PubMed

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