Subtenon Triamcinolone Acetonide versus Intravitreal Triamcinolone Acetonide for the Treatment of Diabetic Cystoid Macular Edema

Abstract

Purpose: To investigate the efficacy of the posterior subtenon (SBT) capsule injection of TA as compared to intravitreal (IVT) injection of Triamcinolone Acetonide (TA) for the management of cystoid diabetic macular edema in pseudophakic patients. Methods: This prospective randomized comparative study included 100 pseudophakic eyes with cystoid macular edema. They were divided into two equal groups; IVT group, treated with 2 mg IVT injection of TA and SBT group, treated with 40 mg SBT injection of TA. Central Subfield thickness SFT, best corrected visual acuity BCVA and intraocular pressure IOP were measured before and after one and three months of treatment Results: There was statistically significant improvement in visual acuity in IVT and SBT groups. The SFT was significantly reduced both after one month and after three months when compared to the baseline values in both IVT and SBT groups. The SFT was comparable between the two groups especially after three months of treatment. The IOP of the eyes treated with IVT and SBT injection was significantly increased when compared to baseline value, but well controlled with glaucoma medication. There was insignificant difference between the IVT and SBT groups as regard to the mean IOP. Conclusion: The subtenon approach of triamcinolone injection can be considered a valid safe and effective alternative to the intravitreal injection; however larger and longer multicenter studies are needed.