Comparison of intravitreal triamcinolone treatment and intravitreal triamcinolone with grid laser treatment in patients with diffuse diabetic macular edema

Abstract

Objective: To compare the efficacy of intravitreal triamcinolone acetonide (IVTA) and IVTA plus macular laser grid photocoagulation therapy in diffuse diabetic macular edema (DME).

Material and methods: Sixteen patients affected by diffuse DME were retrospectively evaulated. Patients were divided into two groups: control group (IVTA injection) and laser group (IVTA plus grid laser). Main outcomes were best corrected visual aquity (BCVA) and central macular thickness (CMT) at the 3(rd) and 6(th) months of treatment. IVTA associated complications and reinjection necessity were assessed.

Results: Our study comprised 18 eyes of 16 patients. The baseline BCVA and CMT were 0.93±0.45 and 530±136μm for the control and 1.02±0.52 and 509±177μm for the laser group respectively. Posttreatment BCVA at the 3(rd) and 6(th) month were 0.73±0.4 and 0.75±0.45 for control and 0.98±0.44 and 1.04±0.4 for laser group respectively (p>0.05 for all). CMT values at the 3(rd) and 6(th) months were 260±174μm (p=0.008) and 362±163 μm (p=0.05) for control and 331±161μm (p=0.05) and 388±215 μm (p>0.05) for laser groups. 55% of control and 66% of laser groups needed reinjection with an avarage of 7±4 months after the first injection. 22% cataract progression and 33% intraocular pressure elevation were noted.

Conclusion: Macular grid laser photocoagulation after IVTA does not have beneficial effects for diffuse DME.

Keywords: Diabetic macular edema (DME); grid laser; intravitreal triamcinolone (IVTA).