Laser photocoagulation combined with subtenon injection of triamcinolone acetonide for diabetic cystoid macular edema.

ABSTRACT

BACKGROUND: To compare the effects of laser photocoagulation combined with subtenon injection of triamcinolone acetonide with photocoagulation alone, for diabetic cystoid macular edema. METHODS: This retrospective comparative study analyzed data for 34 eyes with cystoid macular edema treated with photocoagulation alone (n=17) or combined with triamcinolone (n=17). All patients were followed for 6 months after the procedure. Laser photocoagulation included focal photocoagulation focused on microaneurysms and light grid photocoagulation spread over the edematous retina. Subtenon injection of triamcinolone (20 mg/0.5 cc) was performed in the superior-temporal conjunctiva. RESULTS: In the photocoagulation only group, the pretreatment mean visual acuity (VA) measured by the logarithm of the minimum angle of resolution (LogMAR) was 1.06+/-0.49. The number of laser spots was 34+/-10. The 6 -month post- treatment mean LogMAR was 1.13+/-0.60. In the photocoagulation combined with triamcinolone group, the pretreatment mean LogMAR was 1.31+/-0.49. The number of laser spots was 42+/-14. The 6 -month post- treatment mean LogMAR was 1.26+/-0.49. In the photocoagulation only group, 7 eyes had stable vision (improved, stable or loss of <2 lines) and 8 eyes had vision loss (loss>or=2 lines). In the photocoagulation combined with triamcinolone group, 15 eyes had stable vision and 2 eyes had vision loss. Fewer eyes had vision loss in the photocoagulation combined with triamcinolone group. (chi-square test, p=0.024). CONCLUSIONS: This study, with a follow-up of 6 months, suggests that subtenon injection of triamcinolone combined with macular photocoagulation provides a better chance of stabilizing vision loss in patients with diabetic cystoid macular edema than photocoagulation alone.