Posterior sub‐tenon triamcinolone acetonide for the treatment of diabetic macular edema

Abstract

Purpose: To evaluate the use of posterior sub‐tenon triamcinolone acetonide (PSTA) injection on clinical, angiographic, and optical coherence tomographic (OCT) parameters in diabetic macular edema (DME). Methods: In a prospective clinical sudy, 36 eyes of 33 patients with (DME). and a decrease in visual acuity were included. Posterior sub‐tenon injection of 40 mg of TA was given under topic anesthesia. All patients were evaluated at baseline and at 1 day, 1, 2, 4, 6, and 8 weeks, and 3, 6, and 9 months after injection. In some of the patients injections were repeated after 3 months. Complete ophthalmologic examination, fluorescein angiography, and OCT were performed before intervention and after 3 months. The main outcome measures were visual acuity (VA), central macular thickness(CMT), intraocular pressure (IOP), cataract progression, and frequency of complications. Results: The mean baseline CMT for all eyes was 543μ. The mean CMT was 301μ at 1 month, Twenty‐one of the 36 treated eyes showed visual improvement in at least two lines of visual acuity. Nine eyes showed no improvement in vision. Most of them already had poor visual acuity (0.2 or less) before the injections. Complications of the treatment included cataract in three eyes, glaucoma in one. Injection of repository corticosteroids into the posterior sub‐Tenon space is of value in the treatment of CME secondary to uveitis. However, we have to beware of the complications of treatment. Conclusions: PST injection of TA is effective in reversing CME and improving visual acuity in DME