Comparison of intravitreal versus posterior sub-tenon's capsule injection of triamcinolone acetonide for diffuse diabetic macular edema

Comparison of intravitreal versus posterior sub-tenon's capsule injection of triamcinolone acetonide for diffuse diabetic macular edema

Autor Cardillo, J. A. Google Scholar
Melo, LAS Google Scholar
Costa, R. A. Google Scholar
Skaf, M. Google Scholar
Belfort, R. Google Scholar
Souza-Filho, A. A. Google Scholar
Farah, M. E. Google Scholar
Kuppermann, B. D. Google Scholar
Instituição Hosp Olhos Araraquara
Universidade Federal de São Paulo (UNIFESP)
Univ Calif Irvine
Resumo Purpose: To compare the safety and efficacy of intravitreal versus posterior sub-Tenon's capsule injection of triamcinolone acetonide for diffuse diabetic macular edema.Design: Prospective, double-masked, randomized controlled trial.Participants: Twelve patients (24 eyes) with bilateral diffuse diabetic macular edema.Intervention: One eye of each patient was randomly assigned to receive a single 4-mg triamcinolone acetonide intravitreal injection and the fellow eye to receive a 40-mg triamcinolone acetonicle posterior sub-Tenon's capsule injection.Main Outcome Measures: Changes in visual acuity and central macular thickness obtained using optical coherence tomography were measured during a 6-month follow-up. Potential treatment complications were monitored, including increases in intraocular pressure (IOP) and cataract progression.Results: Both intravitreal and sub-Tenon's capsule injections of triamcinolone acetonicle resulted in significant but transient improvements in central macular thickness. the mean (+/- standard deviation [SD]) central macular thickness in eyes with intravitreal injection was significantly thinner than in the sub-Tenon's capsule-injected eyes at 1 month (226.8 +/- 41.7 mu m and 431.5 +/- 165.8 mu m, respectively; P = 0.002) and 3 months (242.3 +/- 93.9 mu m and 364.7 +/- 78.2 mu m, respectively; P = 0.005) after triamcinolone acetonicle injection. the mean visual acuity (logarithm of the minimum angle of resolution) in the intravitreally injected eyes was significantly better than in the sub-Tenon's capsule-injected eyes at 3 months post injection (0.832 +/- 0.293 and 1.107 +/- 0.339, respectively; P = 0.004). Intraocular pressure did not show any significant difference between the 2 forms of triamcinolone acetonide delivery at any follow-up visit, and no eyes had IOPs > 25 mmHg.Conclusions: the findings from our study neither advocate nor support the use of corticosteroids for the treatment of diabetic macular edema, but do imply that both intravitreal and sub-Tenon's capsule injections of triamcinolone acetonide may be equally tolerated, with short-term performance clearly favoring the intravitreal (4 mg) more than the SBT capsule (40 mg) route for the anatomic and functional aspects of improvement tested in this investigation.
Idioma Inglês
Data de publicação 2005-09-01
Publicado em Ophthalmology. New York: Elsevier B.V., v. 112, n. 9, p. 1557-1563, 2005.
ISSN 0161-6420 (Sherpa/Romeo, fator de impacto)
Publicador Elsevier B.V.
Extensão 1557-1563
Fonte http://dx.doi.org/10.1016/j.ophtha.2005.03.023
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000231544200014
Endereço permanente http://repositorio.unifesp.br/handle/11600/28449

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