Posterior juxtascleral infusion of modified triamcinolone acetonide formulation for refractory diabetic macular edema: One-year follow-up

Abstract

PURPOSE. To evaluate prospectively the efficacy and safety of posterior juxtascleral infusion of a new formulation of triamiabetic macular edema (DME) represents the major cause of decreased visual acuity in diabetic patients. Approxi-cinolone acetonide for refractory diffuse diabetic macular dema. ETHODS. This was an interventional case series. Twenty-two consecutive eyes of 18 patients with refractory diffuse diabetic macular edema were included in the study. Each patient un- derwent a complete ophthalmic examination, including optical coherence tomography (OCT) and digital fluorescein angiography (FA). All patients received a suspension of 40 mg triamcinolone acetonide, 20 mg sodium chondroitin sulfate, and 15 mg sodium hyaluronate (1.5 mL), delivered posteriorly through a conjunctival and Tenon's incision. All patients completed the 1-year follow-up. ESULTS. On average, studied eyes received 1.5 treatments. Mean preoperative foveal thickness (±SD) and visual acuity (±SD) were 474.2±136.6 μm and 0.6±0.37 logarithm of the inimum angle of resolution (logMAR), respectively. The central foveal thickness was significantly reduced from baseline at every follow-up visit (P 0.001). Mean (±SD) reductions in acular thickness were 136±108 μm at 1 week and 128±122 μm after 1 year of follow-up. Mean (±SD) improvement in isual acuity at 12 months was 0.15±0.21 logMAR (P .008). Visual acuity improvement of one or more lines and three or more lines were observed in 14 (63.6%) and 6 (27.3%) eyes, respectively. Seven eyes (31.8%) required topical treatment due to a significant intraocular pressure increase. ONCLUSIONS. Posterior juxtascleral infusion of a new formula- tion of triamcinolone acetonide is an effective treatment for diffuse diabetic macular edema unresponsive to conventional grid laser photocoagulation. A randomized, larger study is warranted. © Association for Research in Vision and Ophthalmology.