Efficacy of Intravitreal Triamcinolone Acetonide for the Treatment of Diabetic Macular Edema

Abstract

This study aimed to report the clinical outcome of intravitreal injections of triamcinolone acetonide (TA) for the treatment of diabetic macular edema (DME). The study enrolled 20 eyes of 19 patients with persistent diabetic macular edema. Full ocular examination including best corrected visual acuity (BCVA), tonometry, retinal examination with +90D lens and average foveal retinal thickness using an optical coherence tomography (OCT) were monitored before and then weekly for up to four weeks after the injection. All eyes received intravitreal triamcinolone acetinide (IVTA) (4 mg/0.1 ml) under topical anesthesia with Proparacaine 0.5% eye drops. BCVA at one week improved by two lines or more in six eyes (30%) and in nine eyes (45%) at four weeks. However, no significant improvement in mean BCVA from baseline was observed at one week (p>0.05) and four weeks (p>0.05). Mean retinal thickness (RT) were 411±179µm at baseline, 349±102µm at one week after the injection (p<0.05), and 380±102µm at four weeks (p>0.05), and 380±159µm at four weeks (p>0.05). One week after the injection, significant regression of macular edema was seen. However recurrence occurred at four weeks. No significant complications such as visual loss, endophthalmitis, significant raise in intraocular pressure or systemic complications developed. In conclusion, no significant changes in BCVA, IOP and RT were observed in the short-term observation after the IVTA. These findings need a larger sample size and a longer term observation to monitor the potential systemic and ocular side effects in Iraqi patients.