Randomised controlled trial of posterior sub-Tenon triamcinolone as adjunct to panretinal photocoagulation for treatment of diabetic retinopathy

Br J Ophthalmol. 2009 Jun;93(6):765-70. doi: 10.1136/bjo.2008.152041. Epub 2009 Feb 12.

Abstract

Aims: To evaluate the efficacy of a single posterior sub-Tenon capsule injection of triamcinolone acetonide (PSTA) before panretinal photocoagulation (PRP).

Methods: This 6-month study involved the randomisation of 82 eyes of 41 patients, with bilateral severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy to a single PSTA 20 mg or to no injection before PRP. The primary end-point was change in best-corrected visual acuity (BCVA) at 6 months compared with that at baseline using the logarithm of the minimum angle of resolution (logMAR). Secondary end-points were changes in retinal thickness and intraocular pressure.

Results: The mean changes in logMAR BCVA at 6 months compared with that at baseline were a worsening of 0.010 (SD 0.029) in the control group (no injection) and an improvement of 0.072 (0.028) in the PSTA group (p = 0.04). The mean changes in foveal thickness at 6 months compared with baseline measurements were an increase of 32.8 (82.8) mum in the control group and a lessening of 9.7 (85.6) mum in the PSTA group (p = 0.03).

Conclusions: PSTA before PRP appears to be beneficial in preventing PRP-induced visual loss in eyes with diabetic retinopathy by reducing the chance of macular thickening.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Inflammatory Agents / therapeutic use*
  • Chemotherapy, Adjuvant
  • Diabetic Retinopathy / drug therapy*
  • Diabetic Retinopathy / pathology
  • Diabetic Retinopathy / physiopathology
  • Diabetic Retinopathy / surgery
  • Female
  • Follow-Up Studies
  • Fovea Centralis / pathology
  • Glucocorticoids / therapeutic use
  • Humans
  • Intraocular Pressure / drug effects
  • Laser Coagulation / adverse effects
  • Laser Coagulation / methods*
  • Macular Edema / etiology
  • Macular Edema / pathology
  • Macular Edema / prevention & control
  • Male
  • Middle Aged
  • Triamcinolone Acetonide / therapeutic use*
  • Visual Acuity / drug effects
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Glucocorticoids
  • Triamcinolone Acetonide