The Effect of Intravitreal Triamcinolone Acetonide Second Injection for Diabetic Macular Edema

ABSTRACT

PURPOSE: To evaluate the outcome of a second intravitreal injection of triamcinolone acetonide for the treatment of diabetic macular edema. METHODS: This clinical series study was carried out on 12 eyes with diabetic macular edema. All patients had shown VA (visual acuity) improvement after the first intravitreal injection of triamcinolone acetonide (4 mg). Following the exhibition of decreased VA and increased foveal thickness, the eyes received a second intravitreal injection. We analyzed the visual acuity and foveal thickness at post-treatment 1, 3, and 6 months by ETDRS (LogMar) and optical coherence tomography (OCT). RESULTS: The mean improvement of visual acuity was 0.24, 0.11, and 0.00 at the 1-, 3-, and 6-month follow-up after the first injection, and was 0.09, 0.00, and -0.20 at the 1-, 3-, 6-month follow-up after the second injection. The mean decrease of foveal thickness was 400, 243, and 109 micrometer at the 1-, 3-, 6-month follow-up after the first injection and 298, 78, and -53 micrometer at the 1-, 3-, and 6-month follow-up after the second injection. The differences of change in foveal thickness after the first and second injections were significant (P=0.02, 0.04, 0.02) but the differences of change in visual acuity were not significant (P=0.14, 0.41, 0.28). CONCLUSIONS: Intravitreal injection of 4 mg of triamcinolone acetonide may increase the visual acuity and may decrease the foveal thickness in the short term, postoperative period, but the second intravitreal injection was less effective than the first injection.