Intravitreal triamcinolone injection for chronic diabetic macula edema

Purpose: To evaluate the effect of intravitreal triamcinolone in eyes with chronic diabetic macular edema unresponsive to prior laser photocoagulation. Material and Method: Thirty four eyes of twenty patients with chronic diabetic retinopathy (seven men, thirteen women), aged 44 to 71 years ( average 60.35±5.9) made up the sutdy population and four mg triamcinolone acetonide was injected into the vitreous cavity. The Visual acuities of the eyes were recorded before treatment and one week, one month, three months, and five months after the treatment. Macula edema was established via FFA and Goldman's three mirrored contact lens. No eyes had a history of glaucoma or ocular hypertansion and vitreoretinal surgery. In this consecutive series, all eyes received previous laser photocoagulation for the treatment of macular edema. Pretreatment visual acuity, intraocular presure and macular edema were compared with post treatment data. After intravitreal triamcinolone acetonide injection the visual and anatomic responses were observed as well as complications related to the injection procedure and corticosteroid medication. Results: The follow-up period of eyes was changed between 4 to 6 month ( mean 5.05±0.76 months). The Visual acuity improved 38.0 % at the first week, 67.6 % in the first month, 76.6 % in the third month, and 70.5 % in the fifth month. Macular edema disappeared 79.9 % in the first month, 88.2 % in the third month, and 79.4 % in the fifth month. Comperison to pretreatment, statistically significant difference was determined in the first, third and fifth months in macular edema resorption. No complication concerning injection except for cataract formation was developed in two eyes. In no eyes intraocular pressure exceeded 21 mmHg. Conclusion: Intravitreal triamcinolone acetonide is a promising therapeutic method for chronic diabetic macular edema unresponsive to prior laser photocoagulation. Further study with longer follow-up and large series is warranted to assess the long-term efficacy and the need for retreatment.Key Words: Diabetic macular edema, triamcinolone acetonide, intravitreal