The efficacy of intravitreal triamcinolone versus laser photocoagulation in the primary treatment of diabetic macular edema

Background Diabetic macular oedema is the leading causes of blindness. Laser photocoagulation reduces the risk of visual loss. However recurrences are common and despite laser treatment, patients with diabetic macular oedema experienced progressive loss of vision. Stabilization of the blood reti...

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Bibliographic Details
Main Authors: Embong, Zunaina, Shaharuddln, Bakiah
Format: Article
Language:English
Published: Pusat Pengajian Sains Perubatan, Universiti Sains Malaysia 2011
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Online Access:http://eprints.usm.my/50708/1/DR.%20ZUNAINA%20EMBONG-Eprints.pdf
http://eprints.usm.my/50708/
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Summary:Background Diabetic macular oedema is the leading causes of blindness. Laser photocoagulation reduces the risk of visual loss. However recurrences are common and despite laser treatment, patients with diabetic macular oedema experienced progressive loss of vision. Stabilization of the blood retinal barrier introduces a rationale for intravitreal triamcinolone treatment in diabetic macular oedema. Objective This study is intended to compare the best corrected visual acuity and the macular oedema index at 3 month of primary treatment for diabetic macular oedema between intravitreal triamcinolone acetonide (IVTA) and laser photocoagulation. Methods This comparative pilot study consists of 40 diabetic patients with diabetic macular oedema. The patients were randomized into two groups using envelope technique sampling procedure. Treatment for diabetic macular oedema was based on the printed envelope technique selected for every patient. Twenty patients were assigned for IVTA group (one injection of !VT A) and another 20 patients for LASER group (one laser session). Main outcome measures were mean BCVA and mean MEI at three months post treatment. The macular oedema index was quantified using Heidelberg Retinal Tomography II. Results The mean difference for best corrected visual acuity at baseline [IVTA: 0.935 (0.223), LASER: 0.795 (0.315)] and at three months post treatment [IVTA: 0.405 (0.224), LASER: 0.525 (0.289)] between !VT A and LASER group was not statistically significant (p = 0.113 and p = 0.151 respectively). The mean difference for macular oedema index at baseline [IVTA: 2.539 (0.914), LASER: 2.139 (0.577)] and at three months post treatment [IVTA: 1.753 (0.614), LASER: 1.711 (0.472)] between IVTA and LASER group was also not statistically significant (p = 0.106 and p = 0.811 respectively). Conclusions IVTA demonstrates good outcome comparable to laser photocoagulation as a primary treatment for diabetic macular oedema at three months post treatment.