Clinical observation of posterior subtenon triamcinolone acetonide for diffuse diabetic macular edema

Abstract

Objective To evaluate the effectiveness and safety of posterior subtenon injection (PSTT) in DME refratory to conventional grid laser photocoagnlation. Methods Thirty-nine cases (42 eyes) with clinical significant DME refratory to grid laser phtotcoagulation were assessed for the inclusion in the study and randomly divided into 2 groups. The PSTT group received 20mg/0.5ml TA and the IVTA group received 4mg/0.1ml TA injection. Complete ophthalmic examination with best-corrected visual acuity (BCVA), optic coherence tomography (OCT) and intraocular pressure (IOP) were performed before and in the 1st, 2nd, and 3rd months of the treatment. Results The BCVA during the treatment in both PSTT group and IVE group was significant increased compared to that ofprctreatment (P<0.01). The mean central foveal thickness during the treatment in both PSTT group and IVE group was significant decreased compared to that of pretreatment (P<0.01). There was no significant difference with respect to the decrease in the central foveal thickness and increase in the visual acuity between the PSTT group and the IVTA group. Significant IOP increase was found in 13.6% of the PSTT group and in 30% of the IVTA group. There was one case of pseudomonas endophthalmitis in the IVTA group. Conclusions Both PSTT and IVTA injections caused a significant increase in visual acuity and a decrease in central foveal thickness, especially in the short term. Although the effect was more pronounced in the IVTA group, the PSTT injection also seemed to be a safe and effective technique for the treatment of DME. Key words: Diabetic maeular edema; Triarncinolone acetonide; Posterior subtenon; Intravitreal injection