Intravitreal triamcinolone acetonide injection as primary treatment for diabetic macular edema

To evaluate the effectiveness of intravitreal triamcinolone injection on the course of diabetic macular edema.

Forty-eight eyes of 48 diabetic patients were treated with 8 mg of intravitreal triamcinolone injection as the primary therapy for diabetic macular edema. The main outcome measures included best-corrected visual acuity, fundus fluorescein angiography, macular edema map values of Heidelberg Retinal Tomograph II (HRT II), and intraocular pressures before and after intravitreal injection.

The visual acuity increased in 41 of 48 eyes (85.4%) during a mean follow-up time of 7.5 months. The mean baseline best-corrected logMAR (logarithm of minimal angle of resolution) value for visual acuities of the patients before intravitreal triamcinolone injection was 1.170.20. After treatment, it was 0.850.29 at 1 month, 0.730.30 at 3 months, and 0.740.31 at 6 months, and the differences were significant when compared with base-line values (for each, p<0.001). The mean edema map values significantly decreased by 36% at the 6-month examinations when compared with preinjection values (p<0.001). Average intraocular pressure rose 24.3%, 29.1%, and 11.8% from baseline at the 1-, 3-, and 6-month follow-up intervals. Intraocular pressure elevation exceeding 21 mmHg was observed in 8 of 48 eyes (16.6%), but was controlled with topical antiglaucomatous medications in all eyes.

Intravitreal triamcinolone application provides significant improvement in visual acuity of diabetic patients and clinical course of macular edema, and may therefore be a promising approach in the primary treatment of diabetic macular edema. (Eur J Ophthal-mol 2004; 14: 543-9).