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Intravitreal cortisone injection for refractory diffuse diabetic macular edema.
1Department of Ophthalmology, Inonu University Turgut Ozal Medical Center, Malatya, Turkey. hamdier@inonu.edu.tr
Summary
Intravitreal triamcinolone acetonide injections offer temporary visual acuity improvement for diabetic macular edema unresponsive to laser treatment. However, long-term efficacy is limited, necessitating repeat injections for sustained benefits.
Area of Science:
- Ophthalmology
- Endocrinology
Background:
- Diabetic macular edema is a leading cause of vision loss in diabetic patients.
- Macular edema unresponsive to grid laser photocoagulation presents a treatment challenge.
Purpose of the Study:
- To evaluate the safety and efficacy of intravitreal triamcinolone acetonide (IVTA) for diffuse diabetic macular edema.
- To compare IVTA with macular grid laser photocoagulation.
Main Methods:
- Thirty patients with refractory diabetic macular edema received IVTA injections.
- A control group of 30 patients underwent grid laser photocoagulation.
- Follow-up ranged from 14-24 months.
Main Results:
- IVTA showed significant visual acuity improvement at 1 and 3 months post-injection compared to baseline and laser treatment.
- 20% of patients required a second injection, and 10% a third, due to visual acuity regression.
- Transient intraocular pressure elevation occurred in 4 patients; one case of sterile endophthalmitis was noted.
Conclusions:
- Intravitreal triamcinolone acetonide provides temporary visual acuity enhancement in diabetic macular edema refractory to laser treatment.
- Long-term stabilization of visual acuity may require repeated injections.
- While generally safe, potential side effects like increased intraocular pressure warrant monitoring.