RESUMO
PURPOSE: To evaluate the effectiveness of intravitreal triamcinolone injection on the course of diabetic macular edema. METHODS: Forty-eight eyes of 48 diabetic patients were treated with 8 mg of intravitreal triamcinolone injection as the primary therapy for diabetic macular edema. The main outcome measures included best-corrected visual acuity, fundus fluorescein angiography, macular edema map values of Heidelberg Retinal Tomograph II (HRT II), and intraocular pressures before and after intravitreal injection. RESULTS: The visual acuity increased in 41 of 48 eyes (85.4%) during a mean follow-up time of 7.5 months. The mean baseline best-corrected logMAR (logarithm of minimal angle of resolution) value for visual acuities of the patients before intravitreal triamcinolone injection was 1.170.20. After treatment, it was 0.850.29 at 1 month, 0.730.30 at 3 months, and 0.740.31 at 6 months, and the differences were significant when compared with base-line values (for each, p<0.001). The mean edema map values significantly decreased by 36% at the 6-month examinations when compared with preinjection values (p<0.001). Average intraocular pressure rose 24.3%, 29.1%, and 11.8% from baseline at the 1-, 3-, and 6-month follow-up intervals. Intraocular pressure elevation exceeding 21 mmHg was observed in 8 of 48 eyes (16.6%), but was controlled with topical antiglaucomatous medications in all eyes. CONCLUSIONS: Intravitreal triamcinolone application provides significant improvement in visual acuity of diabetic patients and clinical course of macular edema, and may therefore be a promising approach in the primary treatment of diabetic macular edema. (Eur J Ophthal-mol 2004; 14: 543-9).
