Posterior subtenon injection of triamcinalone acetonide for cystoids diabetic macular edema

Abstract EN

Objectives : To assess the efficacy and safety of posterior subtenon triamcinolone acetonide injection for the treatment of diabetic cystoid macular edema.

Methods : This prospective, randomized comparative trial included diabetic patients with cystoid macular edema involving 79 eyes.

Forty one eyes were randomly given posterior subtenon triamcinolone acetonide injection while the remaining 38 eyes served as a control group.

The eligibility criteria for this study included patients with clinically and angiographically detectable cystoid macular edema during the past six months, glycosylated hemoglobin not more than 8.5% and history of previous laser treatment not earlier than three months.

All eyes of posterior subtenon triamcinolone acetonide injection group received 40mg of triamcinalone acetonide through a superotemporal approach in the outpatient clinic.

After injection, the visual and anatomical responses were observed at weeks 1, 3, 6, 8, 12, 16, 20 and 24.

Intraocular pressure, incidence of reinjection and complications were also noted.

Results : At one week after injection, all injected eyes showed significant visual acuity improvement from baseline measurements (p<0.001) and 88% of them showed clinical serous macular edema regression.

The most significant improvement in logarithm of the minimum angle of resolution visual acuity was noted at month two post injection.

During the next four months a gradual increase in logarithm of the minimum angle of resolution acuity was noted.

Comparison between the two groups, showed significant difference of mean logarithm of the minimum angle of resolution acuity at one week after injection and during the subsequent study visits.

After injection, recurrence of cystoid macular edema was noted in nine eyes (22%) at a mean time of 5.25±0.71 months.

Two eyes (4.9%) developed rise of intraocular pressure (>20mmHg) at the first week post injection and were treated with antiglaucoma drugs for a mean time of 5.5±1.41 months.

Another two eyes had localized subconjunctival hemorrhage at the site of injection.

Conclusion : Posterior subtenon triamcinolone acetonide injection of 40mg triamcinolone acetonide through a superotemporal approach appears to be safe and effective for short-term management of diabetic cystoid macular edema.