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Efficacy and safety of multiple intravitreal triamcinolone injections for refractory diabetic macular oedema
  1. Mark C Gillies1,
  2. F M Amirul Islam2,
  3. Meidong Zhu1,
  4. Jorgen Larsson1,
  5. Tien Y Wong2
  1. 1
    Save Sight and Eye Health Institute, University of Sydney, Australia
  2. 2
    Centre for Eye Research Australia, University of Melbourne, Australia
  1. 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

Abstract

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.

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Footnotes

  • Funding: This study was supported by grants from the Sydney Eye Hospital Foundation, the Ophthalmic Research Institute of Australia, the Juvenile Diabetes Research Foundation and the Diabetes Australia Research Trust. The study was investigator-initiated and unsupported by the pharmaceutical industry.

  • Competing interests: MG is included as an inventor on patents relating to the formulation of triamcinolone for ocular use and its use for the treatment of retinal neovascularisation but not macular oedema. He has received research funding, as well as honoraria and travel expenses for participation on advisory boards, from Allergan, which is developing steroids for the treatment of macular disease. The other authors have no conflicting or proprietary interests.

  • Abbreviations:
    CMT

    central macular thickness

    DMO

    diabetic macular oedema

    IVTA

    intravitreal triamcinolone

    OCT

    optical coherence tomography

    VA

    visual acuity

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