Efficacy of Suprachoroidal Triamcinolone Acetonide Injection in the Treatment of Resistant Diabetic Macular Edema

Abstract

This study aimed to assess the efficacy of suprachoroidal TA injection for treating diabetic macular edema resistant to anti-VEGF agents. A prospective study was conducted in Ophthalmology Department Service Hospital, Lahore, from December 2020 to December 2021. A total of 60 patients were included in the study. Suprachoroidal TA injection 4 mg/0.1 mL was given after diagnosing resistant DME. The injection was administered every 3 months during the follow-up period (12 months) if intraretinal cysts, intraretinal or subretinal fluid persisted and CMT remained > 250 µm. The primary endpoint was CMT reduction and BCVA improvement after 12 months of injection. The secondary endpoint was assessing the safety of TA injection. The mean CMT at baseline was 478.6±170.1 µm, and after 12 months, it was 230.1 ± 47.5 µm. This decrease was statistically significant (P< .001). The mean BCVA at baseline was 1.194±0.1; after 12 months, it was 0.75±0.2 (P<.001). After one month of injection, IOP reached the maximum value (13.2±0.4 mmHg) compared to the baseline (12.32±0.1mmHg). It gradually declined with the use of topical beta blockers and reached baseline value at 3rd month, and glaucoma surgery was not needed in any patient. Suprachoroidal TA injection effectively treats resistant DMA and leads to SCVA improvement and CMT reduction.

Suprachoroidal Injection: A Novel Approach for Targeted Drug Delivery

“…Several nonrandomized, single-arm studies have also provided evidence supporting the effectiveness of SCTA in improving BCVA and reducing CST with minimal AEs [ 110 , 111 , 112 , 113 , 114 , 115 ]. However, a study by Tharwat and colleagues (2022) suggests that formulated posterior subtenon TA (PSTA) injection may offer better outcomes for managing rDME with reduced risk of IOP elevation.…”