Abstract
Purpose of this study was to validate that Subtenon (SB) Triamcinolone (TA) injection is an alternative to Intravitreal (IV) Triamcinolone (TA) injection for the treatment of diabetic macular edema (DME). Forty eyes were selected having DME due to type 1 or type 2 diabetes. All the patients were treated with photocoagulation. IVTA was administered in one eye and SBTA in following eye of same patient. Improvement in visual acuity, macular edema and intraocular pressure was assessed before treatment and on 2(nd), 4(th), 8(th) and 12(th) week after treatment. After administration of IVTA, MVA was reduced from baseline value (0.805 ± 0.069Log/MAR) to (0.577 ± 0.091 Log/MAR, p<.001) at the end of treatment. Similar results were observed after SBTA administration. MVA was reduced from (0.814 ± 0.082Log/MAR) to (0.49 ± 0.080 Log/MAR, p<.001) at 12(th) week. After IVTA injection Central macular thickness was significantly reduced to (246.8 ± 25 µm, p<0.001) from (390.5 ± 17 µm). There were no significant (p=0.51) difference in both eyes receiving different routes of same treatment. After SBTA injection CMT was significantly reduced to lower values (241.5 ± 27 µm, p<0.001) from (394.4 ± 21 µm). Intraocular pressure after IVTA administration was high (2.32 ± 0.72 mm/Hg, p=0.04) as compared to baseline (1.82 ± 0.94 mm/Hg). Similar pattern was also seen after SBTA administration but to significant extent. Elevation of IoP was observed in both eyes. Subtenon Triamcinolone injection is an alternative to Intravitreal Triamcinolone Injection for Diabetic Macular Edema.
Highlights
According to a survey 3.2% of Chinese population is suffering from Diabetes.[1]
Diabetic retinopathy (DR) ranges from non-proliferative (NPDR) to progressive proliferative DR (PDR) and blindness is caused by macular edema, retinal ischemia, retinal fibrosis, vitreous hemorrhage and retinal detachment
Elevation of intraocular pressure (IoP) was observed in both eyes but more in eyes receiving Intravitrial Triamcinolonacetonide (IVTA) injection
Summary
According to a survey 3.2% of Chinese population is suffering from Diabetes.[1]. Diabetic retinopathy (DR) is sequelae of diabetes that can eventually lead to blindness.[1]. Diabetic Macular Edema (DME) is characterized by microanuerysms and hard exudates that can be detected by stereoscopic examination techniques (SET). Patients having duration of T1DM 5 years and 20 years have incidence 0% to 29% and in case of T2DM ranges from 3% to 28% in same duration respectively.[6] Retinal thickness at or within 500 um is termed as clinically significant macular edema.[4] Intensive diabetic therapy can reduce incidence of NPDR and PDR by 47%.5
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