Muhammad Akmal Khan, Abdul Ghaffar Khan, Abdul Majeed, Afzal Khan Niazi.
Role of intravitreal triamcinolone acetonide in treatment of diabetic macular edema.
J Rawal Med Coll Jan ;12(2):85-7.

Background: To evaluate the effect of single intravitreal triamcinolone acetonide injection on visual acuity of patients suffering from diabetic macular edema. Methods: This interventional randomised control trial.was carried out at Department of Ophthalmology, POF Hospital, Wah Cantt from January to August 2008. Patients having Diabetes Mellitus for more than 10 years and having macular changes amounting to clinically significant macular edema according to Early Treatment Diabetic Retinopathy Study, were selected for the study. There was no sex discrimination. Informed consent was taken All the patients had thorough ophthalmic examination performed with special emphasis on visual acuity, intra ocular pressure (IOP) measurement and fundus examination. Patients were given a single intravitreal injection of commercially available Triamcinolone Acetonide 0.4mg (Kenacart-A, Bristol,Squibb,Myers USA) aseptically in the operating room. They were examined on the first post-operative day and then at 1,2,3 and 6 months post injection. On all visits, visual acuity,IOP and fundi were checked. Result: Out of 36 eyes of 36 patients, only 32 patients completed all their follow-up visits. Those not completing subsequent follow-up were removed from the study. Out of the 32 included patients, 28(87.5%) noted improvement of 01 to 02 Snellen lines of visual acuity. The maximum improvement was noted from 1 to 3 months postoperatively, which was transient, and the improvement in visual acuity faded away after 3 to 6 months. Conclusion: A single intravitreal injection of 0.4mg Triamcinolone Acetonide is effective in improving the visual acuity in a large majority of patients suffering from clinically significant macular edema at 01 to 03 months. However the effects are transient and there is deterioration of vision from 03 months onwards in most of the patients.

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