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Factors associated with visual recovery after sub-Tenon injection of triamcinolone acetonide in diabetic macular edema.
Clin Ophthalmol 2012; 6:1307-14CO

Abstract

BACKGROUND

The purpose of this retrospective chart review was to evaluate factors associated with improvement of visual acuity after a single sub-Tenon injection of triamcinolone acetonide in patients with diabetic macular edema.

METHODS

We reviewed the medical records for 63 consecutive eyes with diabetic macular edema treated by sub-Tenon injection of triamcinolone acetonide and assessed at 2 months postoperatively. We evaluated changes in morphology, foveal photoreceptor status, and parafoveal cystic change, and also measured the central retinal thickness and macular volume. The association of these factors with improvement of vision (logarithm of the minimum angle of resolution, logMAR) was investigated.

RESULTS

Eyes were classified as having cystoid macular edema (CME, n = 52), serous retinal detachment (n = 24), or diffuse diabetic macular edema (n = 4). In eyes with CME, the mean logMAR of visual acuity improved significantly (P = 0.003) from 0.35 ± 0.31 at baseline to 0.29 ± 0.29 after 2 months. However, there was no significant improvement of visual acuity in the eyes with serous retinal detachment or diffuse diabetic macular edema after sub-Tenon injection of triamcinolone acetonide (P = 0.549 and P = 0.545, respectively). The central retinal thickness and macular volume were both reduced significantly after sub-Tenon injection of triamcinolone acetonide in eyes with CME and serous retinal detachment. However, improvement of visual acuity in the eyes with CME was not correlated with the reduction of central retinal thickness or macular volume. Parafoveal cystic changes showed significant improvement after sub-Tenon injection of triamcinolone acetonide in eyes with CME. Photoreceptor status was significantly associated with the visual prognosis in eyes with CME, but not in eyes with serous retinal detachment.

CONCLUSION

Visual acuity improved significantly after sub-Tenon injection of triamcinolone acetonide without photoreceptor recovery in eyes with CME. Improvement of parafoveal cystic changes in the eyes with CME suggests that bipolar cells or their accessory cells might have displayed functional recovery.

Authors+Show Affiliations

Department of Ophthalmology, Kawasaki Medical School, Okayama, Japan.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22927745

Citation

Kawashima, Hiroko, et al. "Factors Associated With Visual Recovery After sub-Tenon Injection of Triamcinolone Acetonide in Diabetic Macular Edema." Clinical Ophthalmology (Auckland, N.Z.), vol. 6, 2012, pp. 1307-14.
Kawashima H, Mizukawa K, Kiryu J. Factors associated with visual recovery after sub-Tenon injection of triamcinolone acetonide in diabetic macular edema. Clin Ophthalmol. 2012;6:1307-14.
Kawashima, H., Mizukawa, K., & Kiryu, J. (2012). Factors associated with visual recovery after sub-Tenon injection of triamcinolone acetonide in diabetic macular edema. Clinical Ophthalmology (Auckland, N.Z.), 6, pp. 1307-14. doi:10.2147/OPTH.S34631.
Kawashima H, Mizukawa K, Kiryu J. Factors Associated With Visual Recovery After sub-Tenon Injection of Triamcinolone Acetonide in Diabetic Macular Edema. Clin Ophthalmol. 2012;6:1307-14. PubMed PMID: 22927745.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors associated with visual recovery after sub-Tenon injection of triamcinolone acetonide in diabetic macular edema. AU - Kawashima,Hiroko, AU - Mizukawa,Kenichi, AU - Kiryu,Junichi, Y1 - 2012/08/10/ PY - 2012/8/29/entrez PY - 2012/8/29/pubmed PY - 2012/8/29/medline KW - cystoid macular edema KW - diabetic macular edema KW - external limiting membrane KW - sub-Tenon injection KW - triamcinolone acetonide SP - 1307 EP - 14 JF - Clinical ophthalmology (Auckland, N.Z.) JO - Clin Ophthalmol VL - 6 N2 - BACKGROUND: The purpose of this retrospective chart review was to evaluate factors associated with improvement of visual acuity after a single sub-Tenon injection of triamcinolone acetonide in patients with diabetic macular edema. METHODS: We reviewed the medical records for 63 consecutive eyes with diabetic macular edema treated by sub-Tenon injection of triamcinolone acetonide and assessed at 2 months postoperatively. We evaluated changes in morphology, foveal photoreceptor status, and parafoveal cystic change, and also measured the central retinal thickness and macular volume. The association of these factors with improvement of vision (logarithm of the minimum angle of resolution, logMAR) was investigated. RESULTS: Eyes were classified as having cystoid macular edema (CME, n = 52), serous retinal detachment (n = 24), or diffuse diabetic macular edema (n = 4). In eyes with CME, the mean logMAR of visual acuity improved significantly (P = 0.003) from 0.35 ± 0.31 at baseline to 0.29 ± 0.29 after 2 months. However, there was no significant improvement of visual acuity in the eyes with serous retinal detachment or diffuse diabetic macular edema after sub-Tenon injection of triamcinolone acetonide (P = 0.549 and P = 0.545, respectively). The central retinal thickness and macular volume were both reduced significantly after sub-Tenon injection of triamcinolone acetonide in eyes with CME and serous retinal detachment. However, improvement of visual acuity in the eyes with CME was not correlated with the reduction of central retinal thickness or macular volume. Parafoveal cystic changes showed significant improvement after sub-Tenon injection of triamcinolone acetonide in eyes with CME. Photoreceptor status was significantly associated with the visual prognosis in eyes with CME, but not in eyes with serous retinal detachment. CONCLUSION: Visual acuity improved significantly after sub-Tenon injection of triamcinolone acetonide without photoreceptor recovery in eyes with CME. Improvement of parafoveal cystic changes in the eyes with CME suggests that bipolar cells or their accessory cells might have displayed functional recovery. SN - 1177-5483 UR - https://www.unboundmedicine.com/medline/citation/22927745/Factors_associated_with_visual_recovery_after_sub_Tenon_injection_of_triamcinolone_acetonide_in_diabetic_macular_edema_ L2 - https://dx.doi.org/10.2147/OPTH.S34631 DB - PRIME DP - Unbound Medicine ER -