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. 2013 Sep;1(3):10.1007/s40135-013-0015-3.
doi: 10.1007/s40135-013-0015-3.

Intravitreal Corticosteroids in the Management of Diabetic Macular Edema

Stephen G Schwartz  1 , Harry W Flynn Jr, Ingrid U Scott
Affiliations

Intravitreal Corticosteroids in the Management of Diabetic Macular Edema

Stephen G Schwartz et al. Curr Ophthalmol Rep. 2013 Sep.

Abstract

Diabetic macular edema (DME) remains an important worldwide cause of visual loss. Corticosteroids have a role in the treatment of some patients with advanced or recurrent DME. The best studied steroids for this indication are triamcinolone acetonide, dexamethasone, and fluocinolone acetonide. All steroids are associated with risks of cataract and intraocular pressure elevation. In addition, intravitreal injection of any medication is associated with risks of infectious endophthalmitis, which has led to the investigation of various extended-release steroid implants. At this time, no steroid is approved by the United States Food and Drug Administration (FDA) for the treatment of DME.

Keywords: Diabetic macular edema; dexamethasone; fluocinolone acetonide; randomized clinical trial; triamcinolone acetonide.

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Conflict of interest statement

Conflict of Interest

Stephen G. Schwartz, Harry W. Flynn, and Ingrid U. Scott declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
A. A 74-year-old female with type 2 diabetes mellitus presented with bilateral recurrent diabetic macular edema (DME) following photocoagulation. Visual acuity was 20/80 OD and 20/200 OS. An optical coherence tomography (OCT) slice OD demonstrates cystoid macular edema (CME) and subretinal fluid. B. An OCT map OD demonstrates macular thickening. C. An OCT slice OS demonstrates CME and subretinal fluid. D. An OCT map OS demonstrates macular thickening. E. The patient was treated with intravitreal triamcinolone acetonide, 4 mg in 0.1 cc, OU. Two months later, visual acuity improved to 20/40 OD and 20/60 OS. An OCT slice OD demonstrates improvement in CME and subretinal fluid. F. An OCT map OD demonstrates improvement in macular thickening. G. An OCT slice OS demonstrates improvement in CME and subretinal fluid. H. An OCT map OS demonstrates improvement in macular thickening.
Figure 1
Figure 1
A. A 74-year-old female with type 2 diabetes mellitus presented with bilateral recurrent diabetic macular edema (DME) following photocoagulation. Visual acuity was 20/80 OD and 20/200 OS. An optical coherence tomography (OCT) slice OD demonstrates cystoid macular edema (CME) and subretinal fluid. B. An OCT map OD demonstrates macular thickening. C. An OCT slice OS demonstrates CME and subretinal fluid. D. An OCT map OS demonstrates macular thickening. E. The patient was treated with intravitreal triamcinolone acetonide, 4 mg in 0.1 cc, OU. Two months later, visual acuity improved to 20/40 OD and 20/60 OS. An OCT slice OD demonstrates improvement in CME and subretinal fluid. F. An OCT map OD demonstrates improvement in macular thickening. G. An OCT slice OS demonstrates improvement in CME and subretinal fluid. H. An OCT map OS demonstrates improvement in macular thickening.
Figure 1
Figure 1
A. A 74-year-old female with type 2 diabetes mellitus presented with bilateral recurrent diabetic macular edema (DME) following photocoagulation. Visual acuity was 20/80 OD and 20/200 OS. An optical coherence tomography (OCT) slice OD demonstrates cystoid macular edema (CME) and subretinal fluid. B. An OCT map OD demonstrates macular thickening. C. An OCT slice OS demonstrates CME and subretinal fluid. D. An OCT map OS demonstrates macular thickening. E. The patient was treated with intravitreal triamcinolone acetonide, 4 mg in 0.1 cc, OU. Two months later, visual acuity improved to 20/40 OD and 20/60 OS. An OCT slice OD demonstrates improvement in CME and subretinal fluid. F. An OCT map OD demonstrates improvement in macular thickening. G. An OCT slice OS demonstrates improvement in CME and subretinal fluid. H. An OCT map OS demonstrates improvement in macular thickening.
Figure 1
Figure 1
A. A 74-year-old female with type 2 diabetes mellitus presented with bilateral recurrent diabetic macular edema (DME) following photocoagulation. Visual acuity was 20/80 OD and 20/200 OS. An optical coherence tomography (OCT) slice OD demonstrates cystoid macular edema (CME) and subretinal fluid. B. An OCT map OD demonstrates macular thickening. C. An OCT slice OS demonstrates CME and subretinal fluid. D. An OCT map OS demonstrates macular thickening. E. The patient was treated with intravitreal triamcinolone acetonide, 4 mg in 0.1 cc, OU. Two months later, visual acuity improved to 20/40 OD and 20/60 OS. An OCT slice OD demonstrates improvement in CME and subretinal fluid. F. An OCT map OD demonstrates improvement in macular thickening. G. An OCT slice OS demonstrates improvement in CME and subretinal fluid. H. An OCT map OS demonstrates improvement in macular thickening.
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