Efficacy and safety of multiple intravitreal triamcinolone injections for refractory diabetic macular oedema

Br J Ophthalmol. 2007 Oct;91(10):1323-6. doi: 10.1136/bjo.2006.113167. Epub 2007 Apr 3.

Abstract

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.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cataract Extraction
  • Diabetic Retinopathy / drug therapy*
  • Diabetic Retinopathy / pathology
  • Diabetic Retinopathy / physiopathology
  • Drug Administration Schedule
  • Female
  • Glucocorticoids / administration & dosage*
  • Glucocorticoids / adverse effects
  • Humans
  • Injections
  • Macula Lutea / pathology
  • Macular Edema / drug therapy*
  • Macular Edema / pathology
  • Macular Edema / physiopathology
  • Male
  • Middle Aged
  • Prospective Studies
  • Treatment Outcome
  • Triamcinolone / administration & dosage*
  • Triamcinolone / adverse effects
  • Visual Acuity / physiology
  • Vitreous Body

Substances

  • Glucocorticoids
  • Triamcinolone