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Randomized Controlled Trial of Posterior Sub-Tenon's Triamcinolone as Adjunct to Panretinal Photocoagulation for Treatment of Diabetic Retinopathy
  1. Noriyuki Unoki (noriharu{at}kuhp.kyoto-u.ac.jp),
  2. Kazuaki Nishijima (nissi{at}kuhp.kyoto-u.ac.jp),
  3. Mihori Kita (mihorik{at}kuhp.kyoto-u.ac.jp),
  4. Kiyoshi Suzuma,
  5. Daisuke Watanabe,
  6. Hideyasu Oh,
  7. Tetsushi Kimura,
  8. Atsushi Sakamoto,
  9. Nagahisa Yoshimura
  1. Department of Ophthalmology, Kyoto University Graduate School of Medicine, Japan
  2. Department of Ophthalmology, Kyoto University Graduate School of Medicine, Japan
  3. Department of Ophthalmology, Kyoto University Graduate School of Medicine, Japan
  4. Department of Ophthalmology, Kyoto University Graduate School of Medicine, Japan
  5. Department of Ophthalmology, Kyoto University Graduate School of Medicine, Japan
  6. Department of Ophthalmology, Kyoto University Graduate School of Medicine, Japan
  7. Department of Ophthalmology, Kyoto University Graduate School of Medicine, Japan
  8. Department of Ophthalmology, Kyoto University Graduate School of Medicine, Japan
  9. Department of Ophthalmology, Kyoto University Graduate School of Medicine, Japan

    Abstract

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

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

    Results: The mean changes in logMAR BCVA at 6 months compared to that at baseline was a worsening of 0.010 ± 0.029 in the control group (no injection) and an improvement of 0.072 ± 0.028 in the PSTA group; this constituted a significant difference (P = .04). The mean change in foveal thickness at 6 months compared to baseline measurements was 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, which was also significant different (P = .03). There were no significant differences between the two groups in IOP at any follow-up point.

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

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