A Three-year Follow-up of Intravitreal Triamcinolone Acetonide Injection and Macular Laser Photocoagulation for Diffuse Diabetic Macular Edema.
10.3341/kjo.2012.26.5.362
- Author:
Hee Yoon CHO
1
;
Se Woong KANG
;
Yun Taek KIM
;
Song Ee CHUNG
;
Seung Woo LEE
Author Information
1. Department of Ophthalmology, Hanyang University School of Medicine, Seoul, Korea.
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Diabetic retinopathy;
Intravitreal injections;
Laser therapy;
Macular edema;
Triamcinolone
- MeSH:
Combined Modality Therapy;
Diabetic Retinopathy/*therapy;
Female;
Fluorescein Angiography;
Follow-Up Studies;
Glucocorticoids/administration & dosage/*therapeutic use;
Humans;
Intravitreal Injections;
Laser Coagulation/*methods;
Macular Edema/*therapy;
Male;
Middle Aged;
Prospective Studies;
Tomography, Optical Coherence;
Treatment Outcome;
Triamcinolone Acetonide/administration & dosage/*therapeutic use;
Visual Acuity
- From:Korean Journal of Ophthalmology
2012;26(5):362-368
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To report the three-year outcomes of macular laser photocoagulation following intravitreal injection of triamcinolone acetonide (IVTA) for diffuse diabetic macular edema (DME). METHODS: A prospective, randomized controlled study was completed. Eighty-six eyes of 74 patients with diffuse DME were randomized into two groups. Eyes assigned to the combination group (n = 48) were subjected to macular laser photocoagulation three weeks after IVTA. Eyes in the IVTA group (n = 38) underwent IVTA alone. Central macular thickness was measured by optical coherence tomography, and the number of additional treatments and mean time to recurrence were assessed. RESULTS: Thirty-seven eyes in the combination group and 26 eyes in the IVTA group completed the three-year follow-up. Recurrence of DME after initial treatment was not observed for nine of the 37 (24.3%) eyes in the combination group or for one of the 26 (3.9$) eyes in the IVTA group (p = 0.028). DME was absent for 19.9 months after treatment in the combination group compared to 10.3 months in the IVTA group (p = 0.027). The mean number of additional treatments was 0.92 in the combination group and 1.88 in the IVTA group (p = 0.001). CONCLUSIONS: Results in the subset of subjects who completed the three-year follow-up demonstrated that laser photocoagulation following IVTA is more effective than IVTA monotherapy for diffuse DME. Combination therapy required fewer additional treatments and resulted in a lower recurrence rate than IVTA monotherapy.
