Abstract

SO.11.04

Combined intravitreal triamcinolone injection and subsequent laser coagulation as treatment for clinical significant macula edema associated with non-proliferative diabetic retinopathy

Timmermann M., Riese J., Loukopoulos V., Meier C., Gerding H.
Department of Retinology, Augenzentrum Klinik Pallas, Olten, Schweiz

Objective: It was the aim of this study to analyze the effectiveness of a combined therapy (triamcinolone and subsequent laser photocoagulation) in patients with clinical significant diabetic macula edema.
Methods: Clinical follow-up of 24 diabetic patients (15 male, 9 female, mean age 68 years, range 55-85ys). Therapy included an intravitreal injection of 4 mg triamcinolone and subsequent one or two sessions of macular laser photocoagulation as soon as a reduction of the edema was evident (latency between injection and laser treatment in the median 23 days (first session) and 32 days (second session, n=9). Follow-up examinations were carried out preoperatively and at one day, one week, two weeks, and one, two, three, and six months after triamcinolone injection, including standardized testing of visual acuity, IOP, anterior segment biomicroscopy, funduscopy, and OCT. Control fluorescence angiography was performed at the three and six month check up.
Results: Visual acuity improved from a baseline level of 0.34 (±0.17, n=24) to 0.41 (±0.24, n=22) at one month, to 0.44 (±0.22, n=24) at three months, and 0.43 (±0.22, n=18) at six months. Central foveal thickness declined from 429 µm (±112, n=20) preoperatively to 312 µm (±69, n=19) at one month, to 328 µm (±108, n=21) at three months, and to 393 µm (±136, n=14) at six months. 9 of 24 were treated with antiglaucomatous eye drops during the observation period. Re-injection was not necessary in any case. All patients presented an improvement of fluorescence angiographic findings.
Conclusions: This study clearly indicates that combined intravitreal triamcinolone injection and laser photocoagulation is resulting in a persistent morphological and functional improvement.

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