Dose Dependent Effects of Intravitreal Triamcinolone Acetonide on Diffuse Diabetic Macular Edema

다국어 초록 (Multilingual Abstract)

Purpose: To evaluate the effect of different doses of intravitreal triamcinolone acetonide on diffuse diabetic macular edema.
Methods: In a retrospective study, 44 eyes with diffuse diabetic macular edema were treated with an intravitreal injection of 4 ㎎ (n=12 eyes), 8 ㎎ (n=17) or 25 ㎎ (n=15) of triamcinolone acetonide (TA). Optical coherence tomography, best-corrected logMAR visual acuity and Goldmann tonometry were performed at baseline, 1 week, and 1, 3, 6, 9 and 12 months after treatment. Mean follow-up was 9.8 months (standard deviation=2.3) with a range of 5-12 months.
Results: The duration of intravitreal TA effects on macular thickness and visual acuity increased with increasing dosage. An observed increase in intraocular pressure induced by TA was not significantly associated with dosage.
Conclusions: In patients with diffuse diabetic macular edema who receive intravitreal TA, effects may last longer after a dosage of 25 ㎎, than after lower doses of 8 ㎎ or 4 ㎎.

참고문헌 (Reference)

1 Klein R, "Visual impairment in diabetes" 91 : 1-9, 1984

2 Wilson CA, "Treatment with intravitreal steroid reduces bloodretinal barrier breakdown due to retinal photocoagulation" 110 : 1155-1159, 1992

3 Jonas JB, "Secondary chronic open- angle glaucoma after intravitreal triamcinolone acetonide" 121 : 729-730, 2003

4 Martidis A, "Intravitreal triamcinolone for refractory diabetic macular edema" 109 : 920-927, 2002

5 Parke DW, "Intravitreal triamcinolone and endophthalmitis" 136 : 918-919, 2003

6 Wingate RJ, "Intravitreal triamcinolone and elevated intraocular pressure" 27 : 431-432, 1999

7 Al-Haddad CE, "Intravitreal triamcinolone acetonide for the management of diabetic papillopathy" 137 : 1151-1153, 2004

8 Massin P, "Intravitreal triamcinolone acetonide for diabetic diffuse macular edema: preliminary results of a prospective controlled trial" 111 : 218-224, 2004

9 Smithen LM, "Intravitreal triamcinolone acetonide and intraocular pressure" 138 : 740-743, 2004

10 Jonas JB, "Intravitreal injection of triamcinolone for diffuse diabetic macular edema" 121 : 57-61, 2003

11 Jonas JB, "Intravitreal injection of crystalline cortisone as adjunctive treatment of proliferative diabetic retinopathy" 131 : 468-471, 2001

12 Jonas JB, "Intraocular pressure after intravitreal injection of triamcinolone acetonide" 87 : 24-27, 2003

13 Jonas JB, "Intraocular injection of crystalline cortisone as adjunctive treatment of diabetic macular edema" 132 : 425-427, 2001

14 Nelson ML, "Infectious and presumed noninfectious endophthalmitis after intravitreal triamcinolone acetonide injection" 23 : 686-691, 2003

15 McDonald HR, "Grid photocoagulation for diffuse macular edema" 5 : 65-72, 1985

16 Benz MS, "Endophthalmitis caused by Mycobacterium chelonae abscessus after intravitreal injection of triamcinolone" 121 : 271-273, 2003

17 Jonas JB, "Endophthalmitis after intravitreal injection of triamcinolone acetonide" 121 : 1663-1664, 2003

18 Photocoagulation for diabetic macular edema, "Early Treatment Diabetic Retinopathy Study report number 1 Early Treatment Diabetic Retinopathy Study Research Group" 103 : 1796-1806, 1985

19 Jonas JB, "Duration of the effect of intravitreal triamcinolone acetonide as treatment of diffuse diabetic macular edema" 138 : 158-160, 2004

20 Spandau UH, "Dosage dependency of intravitreal triamcinolone acetonide as treatment for diabetic macular oedema" 89 : 999-1003, 2005

21 Moshfeghi DM, "Acute endophthalmitis following intravitreal triamcinolone acetonide injection" 136 : 791-796, 2003