Clinical Therapeutic Effects Of Intravitreal Low Dose Triamcinolone Acetonide Combined With Laser Photocoagulation Treatment For Diffuse Diabetic Macular Edema

Objective To evaluate the short time clinical therapeutic efficacy and safety of2mgdose intravitreal triamcinolone acetonide(IVTA) combined with laser photoco-agulationfor diffused diabetic macular edema（DME）.Methods Twenty-five eyes with nonproliferative diabetic retinopathy and diffusedDME received single injection of2mg/0.05mL TA into vitreous. The baseline ex-amination included best-correct visual acuity(BCVA), intraocular pressure(IOP), fu-ndus fluoresecine angiography(FFA) and optical coherence tomography(OCT) mea-sured retinal thickness. The BCVA, thickness of the neurosensory retina，IOP andadverse reaction were measured after the treatment.Results The BCVA of baseline was0.21±0.17.The BCVA at one day follow-up,one week follow-up, one month follow-up, three months follow-up and six mo-nths follow-up were0.23±0.13,0.32±0.17,0.34±0.19,0.35±0.23and0.27±0.17.The BCVA at one week (p=0.003), one month（p=0.001）and three months（p=0.000）was significantly better than that at the baseline. The BCVA at one dayfollow-up had no significant difference with that at baseline（p=0.442）.After sixmonths follow-up, the BCVA declined significantly compared to that at the threemonths (p=0.004), but had no significant difference compared to that at the base-line(p=0.169). After three months follow-up, in all patients, the BCVA improved more than1line was68%(17/25), unchanged was20%(5/20), declined was12%(3/25).After six months follow-up, in all patients, the BCVA improved was48%(12/25), unchanged was16%(4/20), declined was36%(9/25).The central macular thickness at the baseline was543.40±232.55μm.The centralmacular thickness at one day follow-up, one week follow-up, one month follow-up,three months follow-up and six months follow-up were440.92±165.69μm,317.32±127.26μm,254.16±108.59μm,264.96±128.13μm and297.00±140.89μm. Thecentral macular thickness were reduced significantly at one day follow-up, one weekfollow-up, one month follow-up, three months follow-up compared to thebaseline(p=0.000), and it at one month follow-up significantly reduced compared to thatat one week(p=0.000). At the three months, the central macular thickness had nosignificant diffence compare to that at after one month(p=0.392). At six monthsfollow-up, the central macular thickness reduced significantly compared to thebaseline(p=0.000), increased significantly compared to that at three months(p=0.004).The IOP at the baseline was14.80±3.71mmHg. The IOP at one day follow-up,one week follow-up, one month follow-up, three months follow-up and six monthsfollow-up were16.33±4.95mmHg,16.59±3.55mmHg,16.50±2.74mmHg,18.36±4.65mmHg and16.23±2.86mmHg, rised significantly compared to the baseline（P=0.000）,（P=0.014）,（P=0.018）,（P=0.002）,（P=0.041）, but still in the normalrange. The IOP of3eyes were above21mmHg at three months follow-up. All patientshad no complications such as aseptic inflammation, infectious endophthalmitis, vitreoushemorrhage and retinal detachment, except one case of cataract.Conclusion Low dose IVTA combined with laser photocoagulation is a relatively safeand effective treatment method for the short-term control of diffused DME with less complications.