Macular Morphology And Functional Changes After Intravitreal Triamcinolone Acetonide For Macular Edema

PURPOSE: To observe retinal morphology and functional changes after intravitreal Triamcinolone Acetonide for macular edema.METHODS: 37 eyes of 35 patients undergoing intravitreal Triamcinolone Acetonide (IVTA) for macular edema were enrolled in this prospective study. Optical coherence tomography(OCT) and perimetry, fundus fluorescein angiography(FFA) were performed before and 1 month, 3 months, 6 months after IVTA. OCT was performed to measure the neuroepithelial layer thickness of macular fovea. At the same time, perimetry was performed by HumphreyII-750 visual field analysis. We used the central 10-2 fast threshold program to examine the change in central 10 degree. Results of visual field were printed automatically. Statistical analyses were performed by SPSS for Windows using the randomized complete block design ANOVA (two factors and multi-factors analysis of variance). Differences among variables were evaluated by q-test ( Student-Newman-Kueuls method).RESULTS: Best correct visual acuity of all patients after IVTA were better than before. Central macular thickness(CMT)obtained by OCT, Mean CMT before IVTA was 602.53 ± 191.27um, while CMT significantly decreased to 271.80 + 93.77μm 207.87 ±81.88μm 273.87+ 187.17μm at 1,3,6 months after IVTA(P<0.05).The fovea threshold was significantly improved than before IVTA at 1,3,6 months after IVTA(P<0.05). Total sensitivitywas significantly improved than before IVTA at 1,3,6 months after IVTA (P<0.05) in macular 10-2 threshold test. Of the indices of perimetery, Mean Defect has a significant differences among pre- IVTA and post- IVTA and PSD show significant reduction before and after IVTA. (P<0.05). The results of fundus fluorescein angiography show that leakages in macular vascular decreased after IVTA at every follow-up. Intraocular pressure elevated transiently in most patients, but IOP could be controlled by local drops. CONCLUSION: By 6-month of follow-up, macular edema significant resolved and the best-corrected visual acuity significant improved after IVTA . There is a significant decrease in macular leakage on angiography, even part of patients show no leakage. This study shows a treatment benefit from intravitreal triamcinolone in terms of CMT significantly decreased and macular function total sensitivity in 6 degree has great improved, central scotoma decreased. Intraocular pressure elevated transiently in most patients, but IOP could be controlled by local drops. Side effect of TA seldom happened.