Effect of Posterior Subtenon Triamcinolone Acetonide Injection on Diabetic Macular Edema Refractory to Intravitreal Bevacizumab Injection.
- Author:
Min Woo KIM
1
;
Haein MOON
;
Sung Jae YANG
;
Soo Geun JOE
Author Information
- Publication Type:Original Article
- Keywords: Bevacizumab; Macular edema; Posterior subtenon injection
- MeSH: Aged; Angiogenesis Inhibitors/*therapeutic use; Bevacizumab/*therapeutic use; Diabetic Retinopathy/diagnostic imaging/*drug therapy/physiopathology; Female; Glucocorticoids/*administration & dosage; Humans; Injections, Intraocular; Intraocular Pressure/physiology; Intravitreal Injections; Macular Edema/diagnostic imaging/*drug therapy/physiopathology; Male; Middle Aged; Retrospective Studies; Tenon Capsule/*drug effects; Tomography, Optical Coherence; Treatment Failure; Triamcinolone Acetonide/*administration & dosage; Vascular Endothelial Growth Factor A/antagonists & inhibitors; Visual Acuity/physiology
- From:Korean Journal of Ophthalmology 2016;30(1):25-31
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: To evaluate the effects of posterior subtenon triamcinolone acetonide injection on refractory diabetic macular edema (DME) after intravitreal bevacizumab (IVB) injection failure. METHODS: Patients with DME and central subfield thickness (CST) >300 microm who did not respond to IVB injections were retrospectively included. Specifically, we enrolled patients who were diagnosed with refractory DME and who experienced an increase in CST after 1 to 2 IVB injections or no decrease after > or =3 consecutive IVB injections. One clinician injected 20 mg of triamcinolone acetonide into the posterior subtenon space. All patients received ophthalmic examinations at baseline and at 2, 4, and 6 months post-baseline. Examinations included Snellen visual acuity, intraocular pressure, and spectral-domain optical coherence tomography. RESULTS: Forty eyes of 34 patients were included. The average baseline CST was 476 microm. The average CST decreased to 368 microm at 2 months, 374 microm at 4 months, and 427 microm at 6 months (p < 0.001 for all results, Wilcoxon signed-rank test). The average intraocular pressure increased from 15.50 to 16.92 mmHg at 2 months but decreased to 16.30 mmHg at 4 months and 15.65 mmHg at 6 months. Logarithm of the minimum angle of resolution visual acuity improved from 0.56 to 0.50 at 2 months (p = 0.023), 0.50 at 4 months (p = 0.083), and 0.48 at 6 months (p = 0.133, Wilcoxon signed-rank test). No complications were detected. CONCLUSIONS: Posterior subtenon triamcinolone acetonide is an effective and safe treatment for reducing CST in DME refractory to IVB.
