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Published Online First: 3 April 2007. doi:10.1136/bjo.2006.113167
British Journal of Ophthalmology 2007;91:1323-1326
Copyright © 2007 by the BMJ Publishing Group Ltd.

EXTENDED REPORT

Efficacy and safety of multiple intravitreal triamcinolone injections for refractory diabetic macular oedema

Mark C Gillies1, F M Amirul Islam2, Meidong Zhu1, Jorgen Larsson1 and Tien Y Wong2

1 Save Sight and Eye Health Institute, University of Sydney, Australia
2 Centre for Eye Research Australia, University of Melbourne, Australia

Correspondence to:
Professor Mark Gillies, Save Sight and Eye Health Institute, Department of Clinical Ophthalmology, University of Sydney, GPO Box 4337, Sydney NSW 2001, Australia; mark{at}eye.usyd.edu.au

Aim: The efficacy and safety of repeated injections of intravitreal triamcinolone (IVTA) for diabetic macular oedema is unclear, with results of previous reports conflicting.

Methods: This is a prospective, observational case series of 27 eyes receiving IVTA for diabetic macular oedema. LogMAR visual acuity (VA) and central macular thickness (CMT) were measured at baseline and in 3 to 6 monthly intervals for up to 24 months, then correlated with the number of IVTA injections given.

Results: One IVTA injection was required in 6 (18%) eyes, 2 in 8 (24%) eyes, 3 in 13 (39%) eyes and 4–5 in 6 (18%) eyes. VA improved in all patients, but neither the final improvement in VA nor the absolute improvement in CMT from baseline to 24 months correlated with the number of injections received (p = 0.44 and 0.84, respectively). Cataract surgery was more frequent in eyes receiving more injections (p = 0.01).

Conclusions: This study suggests that repeated injections of IVTA continue to be as effective as the first over a 2-year period. The probability of cataract surgery increases with an increasing number of injections.

Abbreviations: CMT, central macular thickness; DMO, diabetic macular oedema; IVTA, intravitreal triamcinolone; OCT, optical coherence tomography; VA, visual acuity


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