Effect of Posterior Subtenon Triamcinolone Acetonide Injection on Diabetic Macular Edema Refractory to Intravitreal Bevacizumab Injection
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Purpose: To evaluate the effects of posterior subtenon triamcinolone acetonide injection on refractory diabeticmacular edema (DME) after intravitreal bevacizumab (IVB) injection failure. Methods: Patients with DME and central subfield thickness (CST) >300 μm who did not respond to IVB injectionswere retrospectively included. Specifically, we enrolled patients who were diagnosed with refractoryDME and who experienced an increase in CST after 1 to 2 IVB injections or no decrease after ≥3 consecutiveIVB injections. One clinician injected 20 mg of triamcinolone acetonide into the posterior subtenon space. Allpatients received ophthalmic examinations at baseline and at 2, 4, and 6 months post-baseline. Examinationsincluded Snellen visual acuity, intraocular pressure, and spectral-domain optical coherence tomography. Results: Forty eyes of 34 patients were included. The average baseline CST was 476 μm. The average CSTdecreased to 368 μm at 2 months, 374 μm at 4 months, and 427 μm at 6 months (p < 0.001 for all results, Wilcoxonsigned-rank test). The average intraocular pressure increased from 15.50 to 16.92 mmHg at 2 monthsbut decreased to 16.30 mmHg at 4 months and 15.65 mmHg at 6 months. Logarithm of the minimum angle ofresolution visual acuity improved from 0.56 to 0.50 at 2 months (p = 0.023), 0.50 at 4 months (p = 0.083), and0.48 at 6 months (p = 0.133, Wilcoxon signed-rank test). No complications were detected. Conclusions: Posterior subtenon triamcinolone acetonide is an effective and safe treatment for reducing CSTin DME refractory to IVB.
Abstract
Purpose: To evaluate the effects of posterior subtenon triamcinolone acetonide injection on refractory diabeticmacular edema (DME) after intravitreal bevacizumab (IVB) injection failure. Methods: Patients with DME and central subfield thickness (CST) >300 μm who did not respond to IVB injectionswere retrospectively included. Specifically, we enrolled patients who were diagnosed with refractoryDME and who experienced an increase in CST after 1 to 2 IVB injections or no decrease after ≥3 consecutiveIVB injections. One clinician injected 20 mg of triamcinolone acetonide into the posterior subtenon space. Allpatients received ophthalmic examinations at baseline and at 2, 4, and 6 months post-baseline. Examinationsincluded Snellen visual acuity, intraocular pressure, and spectral-domain optical coherence tomography. Results: Forty eyes of 34 patients were included. The average baseline CST was 476 μm. The average CSTdecreased to 368 μm at 2 months, 374 μm at 4 months, and 427 μm at 6 months (p < 0.001 for all results, Wilcoxonsigned-rank test). The average intraocular pressure increased from 15.50 to 16.92 mmHg at 2 monthsbut decreased to 16.30 mmHg at 4 months and 15.65 mmHg at 6 months. Logarithm of the minimum angle ofresolution visual acuity improved from 0.56 to 0.50 at 2 months (p = 0.023), 0.50 at 4 months (p = 0.083), and0.48 at 6 months (p = 0.133, Wilcoxon signed-rank test). No complications were detected. Conclusions: Posterior subtenon triamcinolone acetonide is an effective and safe treatment for reducing CSTin DME refractory to IVB.
참고문헌 (40)
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