Purpose: The aim of this study was to analyse the 6-months results of focal laser photocoagulation (LC) applied after previous intravitreal injection of triamcinolone in eyes with non-proliferative diabetic retinopathy and clinically significant diabetic macular edema (DME).
Patients and methods: 32 eyes (32 patients) with DME were included in this study. The number of laser treatments was: 1 in 14 eyes, 2 in 11, 3 in 4 eyes, 4 in 2 and 5 in 1 eye. The first LC was performed at a median of 17 days (mean: 20.3 +/- 6.5, range: 14 - 42 days) after triamcinolone injection. The second, if necessary, at a median of 32.5 (mean: 45.6 +/- 36.6, range: 22 - 144) days after injection.
Results: Mean logMAR visual acuity improved from baseline 0.56 (median: 0.48; 95 %-confidence interval [CI]: 0.41 - 0.71) to 0.47 (median: 0.40, CI: 0.36 - 0.58) after 1 month, and 0.49 (median: 0.40, CI: 0.38 - 0.61) at 3 months, and 0.47 (median: 0.40, CI: 0.36 - 0.58) at 6 months (p < 0.0065). Mean central retinal thickness (OCT-CRT) of optical coherence tomography measurements improved from 417 microm (median: 402.5, CI: 375 - 460 microm) at baseline to 301 microm (median: 280, CI: 271 - 331) at 1 month, 318 microm (median: 305, CI: 276 - 360) at 3 months and 348 microm (median: 329.5, CI: 299 - 398 microm) at 6 months (p = 0.0256). A second combination therapy was performed in 1 eye 3 months after the first injection. In 7 / 32 eyes (22 %) further injections and LC were indicated after 6 months. 8 / 32 eyes received newly prescribed antiglaucomatous medication and 4 / 32 eyes cataract surgery during follow-up.
Conclusion: Focal LC after previous injection of triamcinolone results in an early and in most cases persistent functional improvement in eyes with DME.
Copyright Georg Thieme Verlag KG Stuttgart . New York.