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Br J Ophthalmol 2009;93:765-770 doi:10.1136/bjo.2008.152041
  • Clinical science
    • Original Article

Randomised controlled trial of posterior sub-Tenon triamcinolone as adjunct to panretinal photocoagulation for treatment of diabetic retinopathy

  1. N Unoki,
  2. K Nishijima,
  3. M Kita,
  4. K Suzuma,
  5. D Watanabe,
  6. H Oh,
  7. T Kimura,
  8. A Sakamoto,
  9. N Yoshimura
  1. Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan
  1. Dr K Nishijima, Department of Ophthalmology, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan; nissi{at}kuhp.kyoto-u.ac.jp
  • Accepted 20 January 2009
  • Published Online First 12 February 2009

Abstract

Aims: To evaluate the efficacy of a single posterior sub-Tenon capsule injection of triamcinolone acetonide (PSTA) before panretinal photocoagulation (PRP).

Methods: This 6-month study involved the randomisation of 82 eyes of 41 patients, with bilateral severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy to a single PSTA 20 mg or to no injection before PRP. The primary end-point was change in best-corrected visual acuity (BCVA) at 6 months compared with that at baseline using the logarithm of the minimum angle of resolution (logMAR). Secondary end-points were changes in retinal thickness and intraocular pressure.

Results: The mean changes in logMAR BCVA at 6 months compared with that at baseline were a worsening of 0.010 (SD 0.029) in the control group (no injection) and an improvement of 0.072 (0.028) in the PSTA group (p = 0.04). The mean changes in foveal thickness at 6 months compared with baseline measurements were an increase of 32.8 (82.8) μm in the control group and a lessening of 9.7 (85.6) μm in the PSTA group (p = 0.03).

Conclusions: PSTA before PRP appears to be beneficial in preventing PRP-induced visual loss in eyes with diabetic retinopathy by reducing the chance of macular thickening.

Footnotes

  • Competing interests: None.

  • Funding: Supported by a Grant-in-Aid for Scientific Research from the Ministry of Education, Science and Culture of the Japanese government.

  • Ethics approval: Ethics approval was provided by the Ethics Committee at Kyoto University.

  • Patient consent: Obtained.

  • ▸ A supplemental figure is published online only at http://bjo.bmj.com/content/vol93/issue6

Responses to this article

  • "Authors' Response"
    • Kazuaki Nishijima,
    • Noriyuki Unoki
    Br J Ophthalmol published online October 23, 2009
  • Response to RCT trial of PST as an adjuvant to PRP in Diabetic Retinopathy
    • Dr Kumar Sambhav,
    • Dr Kapil Bhatia M.S, Dr Padmaja Kumari Rani, M.S, FNB (Retina)
    Br J Ophthalmol published online August 11, 2009

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