Decreasing efficacy of repeated intravitreal triamcinolone injections in diabetic macular oedema

Br J Ophthalmol. 2006 Sep;90(9):1137-41. doi: 10.1136/bjo.2006.093211. Epub 2006 May 17.

Abstract

Background/aim: Intravitreal triamcinolone (IVTA) results in transient improvements in diabetic macular oedema (DMO), necessitating repeated injections. The authors report a case series of 10 eyes of 10 patients with DMO, who received a repeat injection of 4 mg IVTA, at least 26 weeks after the first injection of the same dose.

Method: Pre-injection and at 2, 4, 9, and 17 weeks post-injection, best corrected visual acuity (BCVA) and central foveal thickness (CFT) on optical coherence tomography, after the first and repeat injections, were compared using paired t test. Side effects were monitored.

Results: BCVA, CFT, intraocular pressure (IOP), and cataract scores were not significantly different before initial and repeat injections (given at 32.5 (SD 3.5) weeks after the first injection). Transient improvements of BCVA and CFT were achieved after both injections. However, after the repeat injection, the BCVA was significantly worse at all time points (p<0.05) and so were the best achieved CFT and the CFT at 4 weeks post-injection (p = 0.034 and 0.011 respectively), compared with the initial injection. Post-injection maximum IOPs and increase in cataract scores were not significantly different between the two injections.

Conclusion: A repeat injection of 4 mg of IVTA may not be as effective as an initial injection for the treatment of DMO.

MeSH terms

  • Aged
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / therapeutic use
  • Diabetic Retinopathy / drug therapy*
  • Diabetic Retinopathy / pathology
  • Drug Administration Schedule
  • Female
  • Fovea Centralis / pathology
  • Glucocorticoids / administration & dosage*
  • Glucocorticoids / adverse effects
  • Glucocorticoids / therapeutic use
  • Humans
  • Injections
  • Macular Edema / drug therapy*
  • Macular Edema / pathology
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Treatment Outcome
  • Triamcinolone Acetonide / administration & dosage*
  • Triamcinolone Acetonide / adverse effects
  • Triamcinolone Acetonide / therapeutic use
  • Visual Acuity
  • Vitreous Body

Substances

  • Anti-Inflammatory Agents
  • Glucocorticoids
  • Triamcinolone Acetonide