Intravitreal triamcinolone for refractory diabetic macular edema

Martidis, Adam; Duker, Jay S.; Greenberg, Paul B.; Rogers, Adam H.; Puliafito, Carmen A.; Reichel, Elias; Baumal, Caroline R.

doi:10.1016/s0161-6420(02)00975-2

Cited by 923 publications

(660 citation statements)

References 26 publications

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“…Recurrence of macular oedema following ivTA injection is not uncommon. In total, 37.5% of eyes were found to have recurrence of macular oedema 6 months after ivTA injection for refractory diabetic macular oedema in the study by Martidis et al 17 The development of a component of pseudophakic cystoid macular oedema (Irvine-Gass syndrome) is a possible confounding factor in our study and may be more common in diabetic patients undergoing cataract extraction as compared to the incidence in nondiabetics. 24 One limitation of our study is the lack of fundus fluorescein angiography to differentiate between the recurrence of true diabetic macular oedema or Irvine-Gass syndrome after cataract surgery.…”

Section: Discussionmentioning

confidence: 54%

“…15 However, only 14.5% of patients gained visual improvement 3 years after initial grid laser treatment. 16 Martidis et al 17 showed that 4 mg ivTA in patients with CSMO refractory to laser photocoagulation resulted in a mean improvement of 2.4 lines in Snellen visual acuity with anatomical improvement in macular oedema demonstrated by OCT. In contrast, vision in most patients treated with laser photocoagulation tends to stabilise rather than improve.…”

Section: Introductionmentioning

confidence: 99%

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Phacoemulsification with intravitreal triamcinolone in patients with cataract and coexisting diabetic macular oedema: a 6-month prospective pilot study

Lam

Chan

Mohamed

et al. 2004

Eye

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Aims To assess the safety and efficacy of phacoemulsification with intravitreal triamcinolone (ivTA) injection in diabetics with cataract and clinically significant macular oedema (CSMO). Methods A total of 19 eyes of 15 consecutive diabetic patients with cataract and CSMO were prospectively recruited. Patients underwent phacoemulsification and intraocular lens implantation with 4 mg ivTA injection at completion of surgery. Patients were followed up on day 1, then weekly for 1 month, and thereafter monthly until 6 months postoperatively. Best corrected visual acuity (BCVA), central macular thickness (CMT) measured by optical coherence tomography, and adverse events were recorded. Results In total, 17 eyes completed 6 months of follow-up. In all, 58.8% showed improvement in BCVA of X2 lines, with statistically significant improvement in mean Snellen BCVA of 2.4 lines at 6 months. The peak BCVA was achieved at 4 months. The mean CMT decreased from a baseline of 449 mm to a minimum of 3217148 mm (28.5% reduction) achieved at 2 months, with statistically significant reduction at all postoperative time intervals until 6 months. Of 17 eyes, 4 (23.5%) developed transiently elevated intraocular pressure that normalised by 6 months in all but one patient. No injection-or surgery-related complications were encountered.Conclusions Phacoemulsification with concurrent 4 mg ivTA injection appears to be a safe option for managing diabetics with cataract and CSMO. However, large-scaled randomised controlled trials are necessary for delineating the relative contributions of cataract removal and CMT reduction to visual improvement. Moreover, the transient effect on CMT may warrant further studies to determine optimal timing and dosage of further ivTA injections.

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Section: Discussionmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Phacoemulsification with intravitreal triamcinolone in patients with cataract and coexisting diabetic macular oedema: a 6-month prospective pilot study

Lam

Chan

Mohamed

et al. 2004

Eye

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“…[1][2][3] It has gained in popularity as a treatment for macular oedema, as studies have shown improved visual acuity and reduced macular thickness following intravitreal triamcinolone acetonide injection. However, most studies suggesting a treatment benefit have been limited by the short follow-up of treated patients.…”

Section: Introductionmentioning

confidence: 99%

Intravitreal triamcinolone acetonide for macular oedema owing to retinal vein occlusion

Patel

Zaheer

Karia

2006

Eye

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“…3 We believe this may disrupt the blood-ocular barrier, leading to a picture of chronic uveitis. Triamcinolone acetonide has been shown to reduce the breakdown of blood-retinal barrier, 4 introducing the rationale for corticosteroid use in diabetic macular oedema 5 and this case as well.…”

Section: Commentmentioning

confidence: 92%

Fabry disease manifesting as chronic uveitis—treated with enzyme replacement therapy

Yang

2006

Eye

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Intravitreal triamcinolone for refractory diabetic macular edema

Cited by 923 publications

References 26 publications

Phacoemulsification with intravitreal triamcinolone in patients with cataract and coexisting diabetic macular oedema: a 6-month prospective pilot study

Phacoemulsification with intravitreal triamcinolone in patients with cataract and coexisting diabetic macular oedema: a 6-month prospective pilot study

Intravitreal triamcinolone acetonide for macular oedema owing to retinal vein occlusion

Fabry disease manifesting as chronic uveitis—treated with enzyme replacement therapy

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