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Am J Ophthalmol. 2005 Oct;140(4):695-702.

Intravitreal triamcinolone compared with macular laser grid photocoagulation for the treatment of cystoid macular edema.

Author information

1
Sezione di Oftalmologia, Dipartimento di Specialità Medico-Chirurgiche, Università di Catania, Catania, Italy. Clinica.Oculistica@mbox.unict.it

Abstract

PURPOSE:

To evaluate the outcome of cystoid macular edema (CME) treated with intravitreal injections of triamcinolone acetonide (TA), macular laser grid photocoagulation (MLG), or both (TA+MLG).

DESIGN:

Prospective, randomized, interventional, parallel, three-arm clinical trial.

METHODS:

SETTING:

Institutional clinical study.

PATIENTS:

Fifty-six patients (63 eyes) affected by diabetic or retinal vein occlusion CME.

PROCEDURES:

Twenty-two eyes received intravitreal injections of 4 mg TA; 21 eyes underwent MLG; and 20 eyes received intravitreal injection of 4 mg TA, and after 3 months, MLG.

MAIN OUTCOME MEASURES:

Best-corrected visual acuity (VA), central macular thickness (CMT) (by optical coherence tomography), and postoperative complications.

RESULTS:

Mean follow-up was 9 +/- 2 months (range 6 to 12 months). Baseline VA (logarithm of minimal angle of resolution [logMAR]) and CMT were, respectively, 0.82 +/- 0.19 and 556 +/- 139 microm microns for the TA group, 0.84 +/- 0.15 and 601 +/- 102 microm microns for the MLG group, and 0.83 +/- 0.22 and 573 +/- 106 microm microns for the TA+MLG group (no statistically significant difference among the groups). After the treatment, at 45 days, 3, 6, and 9 months in the TA group, VA had improved (P = .004) by 0.26, 0.25, 0.22, and 0.23 logMAR and CMT had decreased by 37%, 33%, 29%, and 31% (P = < .001). In the MLG group, VA was unchanged although CMT had decreased by 5%, 13%, 14%, and 16% (P = .021). In the TA+MLG group, VA had improved (P = .003) by 0.26, 0.24, 0.19, and 0.20 logMAR, and CMT had decreased by 36%, 34%, 28%, and 29% (P = < .001). The groups receiving triamcinolone had better VA and lower CMT values at all time points (P < .05). A reinjection was performed in eight eyes; intraocular pressure increased in nine eyes (treated with medical therapy), and cataract progressed in one eye. No injection-related complications occurred.

CONCLUSIONS:

TA intravitreal injection improves VA and reduces CMT more than MLG, which in triamcinolone-treated eyes does not offer further advantages. Intravitreal TA injection could be used as primary treatment in patients with CME.

PMID:
16226521
DOI:
10.1016/j.ajo.2005.05.021
[Indexed for MEDLINE]

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