Oftalmol Zh.2010;5:38-41.

http://doi.org/10.31288/oftalmolzh201053841

RESULTS OF COMBINED THERAPY OF DIFFUSED DIABETIC MACULAR EDEMA WITH INTRAVITREAL TRIAMCINOLONE ACETONIDE INJECTION AND LASER PHOTOCOAGULATION

Babayeva R. E., Karimov M. I.

Baku,Azerbaijan

Data of treatment of 99 patients (99 eyes) with diabetic macular edema who underwent treatment in Zarifa Aliyeva National Ophthalmology Center in 2007—2008 were analyzed. The patients were divided into 3 groups according to treatment strategy: 1 group — 34 patients (34 eyes) who received only intravitreal injection of 4 mg triamcinolone acetonide, 2 group — 31 patients (31 eyes) who received laser treatment in 2—3 weeks after intravitreal triamcinolone acetonide injection, and 3 group — 34 patients (34 eyes) who received laser photocoagulation only. More marked and durable results as decrease in the macular edema during the period of the follow — up up to 1 year were obtained in combined therapy group (central macular thickness in 1, 2 and 3 groups 532.47±108.5 um, 375.58±125.0 um and 443.76± 139.1 um accordingly). Patients with combined therapy showed better visual acuity results at the end of the 1-year follow-up period (1.06±0.086, 0.83±0.074, 1.05±0.043 in LogMAR units, in 1, 2 and 3 groups accordingly, p=0.041). Percentage of patients with improvement of vision (67.7 %) was higher than in the group with triamcinolone only (29.4 %) and laser only group (8.8 %).

 

References

1.Arevalo J. F., Fromow-Guerra J., Quiroz-Mercado H. Primary intravitreal bevacizumab (Avastin) for diabetic macular edema. Ophthalmology. 2007; 114: 743- 50.
Crossref

2.Aydin E., Demir H. D., Yardim H., Erkorkmaz U. Efficacy of intravitreal triamcinolone after or concomitant with laser photocoagulation in nonproliferative diabetic retinopathy with macular edema. European Journal of Ophthalmology, 2009; 19: 630- 635.
Crossref

3.Bhagat N., Grigorian R. A., Tutela A., Zarbin M. A. Diabetic macular edema: pathogenesis and treatment. Surv. Ophthalmol. 2009: 54:1-32.
Crossref

4.Chun D. W., Heier J. S., Topping T. M. A pilot study of multiple intravitreal injections of ranibizumab in patients with center-involving clinically signii cant diabetic macular edema. Ophthalmology 2006; 113:1706-1712.
Crossref

5.Early Treatment Diabetic Retinopathy Study Research Group. Treatment techniques and clinical guidelines for photocoagulation of diabetic macular edema: Early Treatment Diabetic Retinopathy Study Report Number 2. Ophthalmology 1987; 94:761- 774.
Crossref

6.Holladay J. T. Proper method for calculating average visual acuity. J. Ref. Surg. 1997; 13: 388-391.

7.Johnson M. W. Etiology and treatment of macular edema. Am. J. Ophthalmol. 2009; 147:11-21.
Crossref

8.Jonas J.B, Sufker A. Intraocular injection of crystalline cortisone as adjunctive treatment of diabetic macular ede¬ma. Am J Ophthalmol. 2001;132:425-427.
Crossref

9.Jonas J.B, Kreissig I, Degenring R.F, Kamppeter B. A. Repeated intravitreal injection of triamcinolone acetonide for diffuse diabetic macular oedema. Br. J. Ophthalmol. 2005;89;122.
Crossref

10.Kang S. W., Sa H. — S., Cho H. Y., Kim J. I. Macular grid photocoagulation after intravitreal triamcinolone acetonide for diffuse diabetic macular edema. Arch. Ophthalmol. 2006;124:653-658.
Crossref

11.Kniestedt C., Stamper R. L. Visual acuity and its measurement. Ophthalmol. Clin. N. Am. 2003; 16: 155- 170.
Crossref

12.Lam D. S., Chan C. K., Mohamed S.et al. Intravitreal triamcinolone plus sequential grid laser versus triamcinolone or laser alone for treating diabetic macular edema: six-month outcomes.Ophthalmology. 2007;114(12):2162-2167.
Crossref

13.Martidis A, Duker JS, Greenberg PB et al. Intravitreal triamcinolone for refractory diabetic macular edema. Ophthalmology. 2002 May;109(5):920-7.
Crossref

14.Olk RJ. Modified grid argon (blue-green) laser photocoagulation for diffuse diabetic macular edema. Ophthalmology. 1986 Jul;93(7):938- 50.
Crossref

15.Shimura M., Nakazawa T., Yasuda K.,Shiono T. Comparative therapy evaluation of intravitreal bevacizumab and triamcinolone acetonide on persistent diffuse diabetic macular edema. Am. J. Ophthalmol. 2008; 145: 854-61.
Crossref

16.Yeung C. K., Chan K. P., Chiang S. W. et al. The toxic and stress responses of cultured human retinal pigment epithelium (ARPE19) and human glial cells (SVG) in the presence of triamcinolone. Invest. Ophthalmol. Vis. Sci. 2003; 44: 5293-300.
Crossref

17.Yu Fei, Afifi A. A. Descriptive statistics in ophthalmic research. Am. J. Ophthalmol. 2009; 147: 389- 391.
Crossref