Jornal de Oftalmologia Clínica e Experimental
Acesso livre

Abstrato

Intravitreal Triamcinolone Injection as an Adjuvant to Standard Laser Therapy in Management of Proliferative Diabetic Retinopathy

Hooshang Faghihi, Ahmad Mirshahi, Hamideh Shenazandi, Aalireza lashay, Mahnaz Abdollahian, Saied Dianat and Ali Abdollahi

Purpose: To evaluate efficacy and safety of combined intravitreal triamcinolone acetonide (IVTA) injection plus panretinal photocoagulation (PRP) in comparison with PRP in proliferative diabetic retinopathy (PDR).
Methods: 38 eyes of nineteen patients with PDR were enrolled. One eye of each patient was randomly selected to undergo IVTA injection one week prior to PRP session (IVTA eye), and contralateral eye treated with PRP alone (control eye). Patients were followed at 1, 4 and 6 months after treatment. Main outcome measures included change in logarithm of the minimum angle of resolution best-corrected visual acuity (logMAR BCVA), central macular thickness (CMT) and complications.
Results: Mean baseline logMAR BCVA was 0.41±0.36 (IVTA eyes) and 0.36±0.30 (control eyes). At 6 months, Mean change of visual acuity to logMAR BCVA was - 0.054±0.114 (IVTA eyes) and 0.053±0.145 (control eyes) (p=0.02). Mean baseline CMT was 274.5±61.7 µm (IVTA eyes) and 246.7±74.7 µm (control eyes). Injected eyes showed significant reduction in mean CMT at all visits. However, there was no significant difference for CMT between IVTA and control eyes at all visits. Significant reduction of CMT in IVTA eyes was observed at 1 month from 319.2±79.1 to 260.5±78.5 (p=0.024). At 6 months, CMT reduction was still significant in IVTA eyes as compared with baseline values (p=0.048). In control eyes, CMT was not significantly reduced at 1 and 6 months of treatment.
Conclusions: IVTA injection is a relatively safe method which might have prophylactic role against visual acuity exacerbation and macular edema secondary to PRP in PDR eyes.