Nadeem Ishaq.
Role of intravitreal triamcinolone acetonide injection in treating refractory diabetic macular edema.
Al-Shifa J Ophthalmol Jan ;1(1):30-3.

Purpose: To study the effect of intravitreal triamcinolone in patients with diffuses macular edema refractory to laser treatment. Study Design: Prospective interventional case series: Intervention: Intravitreal triamcinolone injection Participants: 54 eyes of 42 patients with diffuse diabetic macular edema refractory to laser treatment were enrolled in this study.10 patients had regular follow up. Methodology: Intravitreal; injection of triamcinolone acetonide 4 mg in 0.1 ml was given through a 27-g needle in the inferotemporal pars plana 3.5 mm posterior to the limbus under topical anesthesia. After the injection, IOP, indirect ophthalmoscopy, fundus intravitreal location of the triamcinolone. Results: Improvement in visual acuity was found in 39[82%] patients. The mean improvement of acuity was 1, 2, 4,2 Snellen lines at the 6wks, 8wks, 12wks,and 243wks follow-up intervals respectively. Intraocular pressure increase was observed in 21[44%] eyes. At 12wks follow-up only 2 eyes had persistence of high IOP up to 32 mm hg and received combination therapy of topical prostaglandin analog and beta blockers. Two eyes exhibited cataract progression at six months. Re-injection was performed after six months in 13[27%] of27 because of recurrence of diabetic macular edema. Conclusion: Intravitreal triamcinolone is a promising therapy for patients with diabetic macular edema refractory to laser treatment. It is effective in improving vision, reducing macular thickness and inducing re-absorption of hard exudates.

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