ABSTRACT
Purpose: is to study the morphological changes in Diabetic Macular Edema [DME] before and after intravitreal injection of triamcinolone acetonide using the spectral domain-optical coherence tomography [SD-OCT] parameters
Patient and methods: The study was held at Al-Zahraa University Hospital. It included 49 eyes of 40 patients with clinically significant diabetic macular edema [CSDME]. A single intravitreal injection of triamcinolone acetonide [IVTA] at the dose of 4 mg in 0.1 ml was administered. Best corrected visual acuity [BCVA], intraocular pressure [IOP] and OCT scanning of the macula were done before and 3 months after IVTA. The OCT study parameters included central foveal thickness [CFT], OCT pattern of DME, vitreomacular interface [VMI], presence or absence of serous macular detachment [SMD], hard exudates [HEs], hyper-reflective spots [HRS] and IS/OS junction [Foveal ellipsoid zone] and ELM integrity
Results: Mean BCVA +/- SD were [0.23 +/- 0.13] and [0.39 +/- 0.22] pre and 3 months after IVTA respectively. The initial mean CFT +/- SD was [424 +/- 127.1 um] while 3 months after IVTAit was [283.1 +/- 70.2 um]. Eighteen eyes showed SMD which was completely absent 3 months after a single IVTA. There was insignificant statistical difference of the VMI state before and 3 months after IVTA. Out of thirty-four eyes that showed the presence of HEs in this study, twenty-seven eyes showed diminution of these HEs size 3 months after injection. Forty-one eyes and forty-three eyes showed the presence of HRS before and after IVTA respectively. There was insignificant statistical difference in foveal ellipsoid zone and ELM integrity before and 3 months after IVTA. Complications were reported in 16 eyes [32.6%]. Cataract progression was noted in 6 eyes [12.2 %]. Steroid induced IOP elevation was reported in 10 eyes [20.4%]
Conclusions: The data collected from OCT macular B scan are effective in the prognosis and follow up of diabetic macular edema. IVTA remains a promising primary therapy for DME at least in short terms. It seems relatively safe, but not without complications