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  • Effect of intravitreal triamcinolone acetonide injection at the end of vitrectomy for vitreous haemorrhage related to proliferative diabetic retinopathy

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Clinical science
Effect of intravitreal triamcinolone acetonide injection at the end of vitrectomy for vitreous haemorrhage related to proliferative diabetic retinopathy
  1. Yoshihiro Takamura1,
  2. Masahiko Shimura2,
  3. Takashi Katome3,
  4. Hideaki Someya4,
  5. Masahiko Sugimoto5,
  6. Takao Hirano6,
  7. Taiji Sakamoto7,
  8. Makoto Gozawa1,
  9. Takehiro Matsumura1,
  10. Masaru Inatani1
  11. for the writing committee of Japan-Clinical Retina Research Team (J-CREST)
  1. 1 Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Yoshida, Fukui, Japan
  2. 2 Department of Ophthalmology, Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo, Japan
  3. 3 Department of Ophthalmology and Visual Neuroscience, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan
  4. 4 Department of Ophthalmology, National Defense Medical College, Tokorozawa, Japan
  5. 5 Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Japan
  6. 6 Department of Ophthalmology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
  7. 7 Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
  1. Correspondence to Dr Yoshihiro Takamura, Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Yoshida, Fukui 910-1193, Japan; ytakamura{at}hotmail.com

Abstract

Background/Aims To investigate whether intravitreal injection of triamcinolone acetonide (IVTA) combined with vitrectomy prevents postoperative inflammation in patients with vitreous haemorrhage (VH) due to proliferative diabetic retinopathy (PDR).

Methods This prospective, multicentre, randomised study conducted at seven sites in Japan enrolled patients diagnosed as having VH following PDR. Patients underwent vitrectomy with (IVTA+VIT group) or without (VIT group) IVTA at the end of the surgery. Anterior flare intensity (AFI), central retinal thickness (CRT), best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were measured before and at 3 days, 1 week, 1, 3 and 6 months after surgery and compared.

Results Number of patients who completed 6 months of follow-up was 40 and 41 in VIT group and IVTA+VIT group, respectively. AFI was significantly higher in the VIT group than in the IVTA+VIT group at 3 days (P=0.033), 1 week (P=0.019) and 1 month (P=0.037). There were no significant differences in CRT, BCVA and IOP between the groups through the observational periods. In the cases with macular oedema >350 µm of CRT at 3 days, CRT was significantly lower in the IVTA+VIT group than in the VIT group at 1 month (P=0.041).

Conclusions IVTA combined with vitrectomy and cataract surgery contributed to inhibit the postoperative inflammation in patients with VH due to PDR. The effect of IVTA in the reduction of diabetic macular oedema may be limited to the early stage after surgery.

Trial registration number UMIN000020376, Post-results.

  • inflammation
  • treatment surgery

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bjophthalmol-2017-311377

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    Footnotes

    • Contributors YT: conception or design of the work, data collection, data analysis and interpretation, drafting the article, critical revision of the article. MShi: data collection. TK: data collection. HS: data collection. MSu: data collection. TH: data collection. TS: conception or design of the work. MG: data collection. TM: data analysis and interpretation. MI: data analysis and interpretation.

    • Funding Publication of this article was supported in part by grants-in-aid for scientific research (number 24592620) from the Japan Society for the Promotion of Science, Tokyo, Japan.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval The University of Fukui Institutional Review Board.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Collaborators Japan-Clinical Retina Research Team (J-CREST).

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