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Efficacy and safety of multiple intravitreal triamcinolone injections for refractory diabetic macular oedema
Mark C Gillies1, F M Amirul Islam, Meidong Zhu
1Save Sight and Eye Health Institute, Department of Clinical Ophthalmology, University of Sydney, GPO Box 4337, Sydney NSW 2001, Australia. mark@eye.usyd.edu.au
Aim:
The efficacy and safety of repeated injections of intravitreal triamcinolone (IVTA) for diabetic macular oedema is unclear, with results of previous reports conflicting.
Methods:
This is a prospective, observational case series of 27 eyes receiving IVTA for diabetic macular oedema. LogMAR visual acuity (VA) and central macular thickness (CMT) were measured at baseline and in 3 to 6 monthly intervals for up to 24 months, then correlated with the number of IVTA injections given.
Results:
One IVTA injection was required in 6 (18%) eyes, 2 in 8 (24%) eyes, 3 in 13 (39%) eyes and 4-5 in 6 (18%) eyes. VA improved in all patients, but neither the final improvement in VA nor the absolute improvement in CMT from baseline to 24 months correlated with the number of injections received (p = 0.44 and 0.84, respectively). Cataract surgery was more frequent in eyes receiving more injections (p = 0.01).
Conclusions:
This study suggests that repeated injections of IVTA continue to be as effective as the first over a 2-year period. The probability of cataract surgery increases with an increasing number of injections.
