Intravitreal Injection of Triamcinolone for Refractory Diabetic Macular Edema

Purpose: To determine the efficacy and safety of intravitreal triamcinolone acetonide given to treat diabetic macular edema that was unresponsive to a prior laser photocoagulation. Methods: An intravitreal injection of 4 mg triamcinolone acetonide was given to 25 eyes with a clinically significant diabetic macular edema (CSME) that failed to respond to conventional treatment within an average of 7.56 months after laser photocoagulation. There were 13 females and 4 bilateral cases. The mean age was 60.46.9 years. The response to treatment was monitored functionally by a visual acuity assessment and anatomically by an OCT macular thickness at 1-, 2-, and 6-month intervals after the injection. Results: After the intravitreal injection of triamcinolone acetonide, 18 out of 25 eyes (72%), 20 out of 25 eyes (80%), and 13 out of 18 eyes (72%) showed improvement of the mean visual acuity at the 1-, 2-, and 6-month follow-up intervals. The central macular thickness as measured by the OCT decreased by 43%, 45%, and 20%, respectively, over these same intervals from an initial pretreatment mean of 498.7131.6 . The postoperative complications were an intraocular pressure elevation (3 eyes), and cataract (3 eyes). However, there were no serious postoperative complications such as retinal detachment, vitreous hemorrhage and endophthalmitis. Conclusions: An intravitreal injection of triamcinolone acetonide may be useful for treating a diabetic macular edema that is resistant to conventional laser photocoagulation.