Embong, Zunaina and Shaharuddln, Bakiah
(2011)
The efficacy of intravitreal triamcinolone versus laser
photocoagulation in the primary treatment of diabetic
macular edema.
The efficacy of intravitreal triamcinolone versus laser photocoagulation in the primary treatment of diabetic macular edema.
Abstract
Background
Diabetic macular oedema is the leading causes of blindness. Laser photocoagulation reduces the
risk of visual loss. However recurrences are common and despite laser treatment, patients with
diabetic macular oedema experienced progressive loss of vision. Stabilization of the blood
retinal barrier introduces a rationale for intravitreal triamcinolone treatment in diabetic macular
oedema.
Objective
This study is intended to compare the best corrected visual acuity and the macular oedema index
at 3 month of primary treatment for diabetic macular oedema between intravitreal triamcinolone
acetonide (IVTA) and laser photocoagulation.
Methods
This comparative pilot study consists of 40 diabetic patients with diabetic macular oedema. The
patients were randomized into two groups using envelope technique sampling procedure.
Treatment for diabetic macular oedema was based on the printed envelope technique selected for
every patient. Twenty patients were assigned for IVTA group (one injection of !VT A) and
another 20 patients for LASER group (one laser session). Main outcome measures were mean
BCVA and mean MEI at three months post treatment. The macular oedema index was quantified
using Heidelberg Retinal Tomography II.
Results
The mean difference for best corrected visual acuity at baseline [IVTA: 0.935 (0.223), LASER:
0.795 (0.315)] and at three months post treatment [IVTA: 0.405 (0.224), LASER: 0.525 (0.289)]
between !VT A and LASER group was not statistically significant (p = 0.113 and p = 0.151
respectively). The mean difference for macular oedema index at baseline [IVTA: 2.539 (0.914),
LASER: 2.139 (0.577)] and at three months post treatment [IVTA: 1.753 (0.614), LASER: 1.711
(0.472)] between IVTA and LASER group was also not statistically significant (p = 0.106 and p
= 0.811 respectively).
Conclusions
IVTA demonstrates good outcome comparable to laser photocoagulation as a primary treatment
for diabetic macular oedema at three months post treatment.
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