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Dosage dependency of intravitreal triamcinolone acetonide as treatment for diabetic macular oedema
  1. U H M Spandau1,2,
  2. M Derse1,
  3. P Schmitz-Valckenberg1,
  4. C Papoulis1,
  5. J B Jonas2
  1. 1Department of Ophthalmology, Evangelisches Stift, Koblenz, Germany
  2. 2Department of Ophthalmology, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Germany
  1. Correspondence to: Dr U Spandau Universitäts-Augenklinik, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany;


Aim: To evaluate the effect of different doses of intravitreal triamcinolone acetonide on diffuse diabetic macular oedema.

Methods: The prospective, randomised, double masked, clinical interventional study included 27 eyes (27 patients) with diffuse diabetic macular oedema. They were randomly divided into three study groups receiving an intravitreal injection of filtered triamcinolone acetonide of about 2 mg (n = 8 eyes), 5 mg (n = 10), or 13 mg (n = 9), respectively. Dosage measurement was performed before filtration. Mean follow up was 6.6 (SD 2.4) months (3–12 months). Main outcome measures were visual acuity and intraocular pressure.

Results: Maximal increase in visual acuity was significantly (p = 0.046; 95% CI: 0.032 to 2.99; r = 0.38) correlated with the dosage of intravitreal triamcinolone acetonide. Additionally, the duration of the effect of intravitreal triamcinolone acetonide increased significantly with the dosage of intravitreal triamcinolone acetonide (r = 0.45; p = 0.014). Increase in intraocular pressure during follow up was statistically not significantly associated with the dosage used (p = 0.77).

Conclusions: In patients with diffuse diabetic macular oedema receiving intravitreal triamcinolone acetonide, treatment response may last longer and be more pronounced with a dosage of 13 mg than in lower doses of 5 mg or 2 mg. Triamcinolone acetonide induced increase in intraocular pressure may not be markedly associated with the dosage used.

  • diabetic retinopathy
  • corticosteroids
  • macular oedema
  • intravitreal drug delivery

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  • Competing interests: none declared

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