Evaluation of the Effect of Suprachoroidal Triamcinolone Injection on Refractory Diabetic Macular Edema

Purpose:  To assess the safety and efficacy of supra choroidal triamcinolone injection (SCT) in cases of refractory diabetic macular oedema. Study Design:  Interventional case series. Place and Duration of Study:  Lahore General Hospital, Lahore, from July to December 2019. Methods:  A total of 22 eyes of patients above 18 years of age, with either Type-1 or Type-2 diabetes mellitus and treatment resistant central Diabetic Macular Edema (DME) of 320 um or more (measured on Zeiss Cirrus HD-OCT) and Best Corrected Visual Acuity (BCVA) of less than or equal to 20/40 were included in the study. BCVA, Intra Ocular Pressure (IOP) and Central Subfield Thickness (CST) was recorded. After Supra-Choroidal triamcinolone (SCTA), patients were followed up at one and three months and same clinical parameters were recorded and the results were analysed. Results:  out of 22 patients, 10 (45.45%) were males and 12 (54.54%) were females. Mean pre injection CST was 615.5 ± 200.28 um and Log MAR BCVA was 0.9 ± 0.20. Mean post injection CST at one and three months was 302.45 ± 52.45 and 301.66 ± 55.82 um. Mean post injection Log MAR BCVA at one and three months was 0.52 ± 0.3 and 0.40 ± 0.22. The results were statistically significant for pre and post injection CST at both one and three months (p-value < 0.00001). Pre and post injection BCVA was also statistically significant (p-value < 0.05). Conclusion:  CST is a safe and effective means to reduce refractory diabetic macular edema and improve OCT macular thickness. Key Words:  Diabetic macular edema, Suprachoroidal Triamcinolone, Central sub-field thickness.