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Comparison of combination posterior sub-tenon triamcinolone and modified grid laser treatment with intravitreal triamcinolone treatment in patients with diffuse diabetic macular edema

Yonsei Medical Journal, 2008, 49(6), , pp.955-964 [Peer Reviewed Journal]

Copyright © 2008 The Yonsei University College of Medicine 2008 ;ISSN: 0513-5796 ;EISSN: 1976-2437 ;DOI: 10.3349/ymj.2008.49.6.955 ;PMID: 19108019

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  • Title:
    Comparison of combination posterior sub-tenon triamcinolone and modified grid laser treatment with intravitreal triamcinolone treatment in patients with diffuse diabetic macular edema
  • Author: Chung, Eun Jee ; Freeman, William R ; Azen, Stanley P ; Lee, Hyo ; Koh, Hyoung Jun
  • Subjects: Adult ; Aged ; Anti-Inflammatory Agents - administration & dosage ; Diabetic Retinopathy - drug therapy ; Diabetic Retinopathy - physiopathology ; Diabetic Retinopathy - surgery ; Female ; Fovea Centralis - pathology ; Humans ; Laser Coagulation ; Macular Edema - complications ; Macular Edema - drug therapy ; Macular Edema - physiopathology ; Macular Edema - surgery ; Male ; Middle Aged ; Original ; Prospective Studies ; Triamcinolone - administration & dosage ; Visual Acuity ; Vitreous Body ; 의학일반
  • Is Part Of: Yonsei Medical Journal, 2008, 49(6), , pp.955-964
  • Description: To compare the efficacy of posterior sub-Tenon's capsule triamcinolone acetonide injection combined with modified grid macular photocoagulation (PSTI + MP) with intravitreal triamcinolone acetonide (IVTA) injection in the treatment of diffuse diabetic macular edema (DME). Forty eyes of 33 patients with diffuse DME were randomly allocated into either PSTI + MP (20 eyes) or IVTA (20 eyes). Best corrected visual acuity (VA) and foveal thickness were measured. The ETDRS scores at baseline were 25.2 +/- 13.6 (mean +/- SD) letters in the PSTI + MP group, whereas 21.7 +/- 16.3 letters in the IVTA group. The ETDRS scores improved by 33.2 +/- 15.9, 34.7 +/- 16.6 and 30.9 +/- 19.0 letters in the PSTI + MP group whereas by 30.9 +/- 15.4, 30.1 +/- 17.9 and 31.5 +/- 15.0 letters in the IVTA group at 1, 3, and 6 months after the treatments, respectively. The VA improved significantly at 1 month and 3 months after both treatments (all p < 0.02, paired t-test). The VA improvements were no longer significant at 6 months in either group. There were no statistically significant differences at any time points between the 2 groups (all p > 0.05, Student's t-test). The foveal thicknesses at baseline and 1, 3, and 6 months after the treatments were 382.8 +/- 148.3, 309.1 +/- 131.3, 319.3 +/- 93.3, 340.4 +/- 123.5 microm (mean +/- SD) in the PSTI + MP group vs. 369.1 +/- 123.1, 241.4 +/- 52.3, 277.5 +/- 137.4, 290.2 +/- 127.9microm in the IVTA group, respectively. Pairwise comparisons revealed significant decrease in foveal thickness at 1 month (p = 0.01, paired t-test) for the PSTI + MP group, and at both 1 month (p < 0.001) and 3 months (p = 0.016) for the IVTA group. There were no statistically significant differences at any time points between the 2 groups (all p > 0.05, Student's t-test). In contrast to the PSTI + MP group, where no complications were noted, the elevation of intra-ocular pressure in 3 of 20 eyes (15%) and a significant increase in average cataract grading were observed in the IVTA group. PSTI + MP treatment provides significant improvement of vision in patients with diffuse DME over 3 months, and achieves outcomes comparable to those after IVTA treatment, however, with fewer complications.
  • Publisher: Korea (South): Yonsei University College of Medicine
  • Language: English
  • Identifier: ISSN: 0513-5796
    EISSN: 1976-2437
    DOI: 10.3349/ymj.2008.49.6.955
    PMID: 19108019
  • Source: KoreaMed Synapse
    GFMER Free Medical Journals
    MEDLINE
    PubMed Central
    KoreaMed Open Access
    DOAJ Directory of Open Access Journals
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