INTRAVITREAL TRIAMCINOLONE IN DIABETIC MACULAR EDEMA : A COMPARATIVE STUDY OF 1 MG AND 4MG DOSES

Macular edema is a frequent manifestation of diabetic retinopathy and animportant cause of visual disturbance in diabetic patients. AIM: To compare the efficacy and safety of 1mg and 4mg intravitreal triamcinolone acetonide (IVTA) in the management of diabetic macular edema. SETTING: Sarojini Devi Eye Hospital, Hyderabad. MATERIAL AND METHODS: 42 eyes of 42 patients with diabetic macular edema were randomly assigned toreceive either 1-mg or 4-mg dose of Intravitreal triamcinolone acetonide (IVTA). Each patient underwent a complete comprehensive eye examination at baseline andat each visit.Fundus fluorescein angiography and optical coherence angiographywas done at baseline and at 1, 3 and 6 months.BCVA, lens status, IOP wererecorded at each follow up visit. Each patient’s BCVA was measured in snellen’s lines and converted into logarithm of minimum angle of resolution (log MAR) scale for analysis. STATISTICAL ANALYSIS USED: The data were statistically evaluated using the Wilcoxon signedrank test, Mann-Whitney test and t tests wherever applicable. A p value of lessthan.05 was considered significant. RESULTS: There was no statistically significant difference in the mean foveal thickness measurement at baseline (p=.723) or at 3rd month (p=.878) between the sub-groups. BCVA significantly improved from baseline to subsequent visits in both the groups, but there was no statistically significant difference observed in the mean baseline BCVA between the two sub-groups (p=.754). There was no statistically significant difference observed in IOP between the two sub-groups at any follow up visit. CONCLUSIONS: The results of our study suggest that 1-mg dose of IVTA is as effective as 4-mgdose of IVTA in improving the functional and anatomical outcome in macularedema associated with diabetic retinopathy.