This article tells about the study on the safety and efficacy of anterior and posterior sub-Tenon injections of triamcinolone. The injections involved in the investigation were given either alone or in combination with focal photocoagulation. These interventions were designed for the treatment of mild diabetic macular edema or DME. Macular edema happens when fluid and protein deposits collect on or under the macula of the eye. The macula is the yellow central area of the retina. You can see the macula of the eye clearly under a microscope.

The collection of protein deposits in the macula causes it to thicken and swell. The swelling may result to a distortion in a person’s central vision. The investigation was a randomized clinical trial. There were one hundred nine patients with mild DME in the said investigation. The people to be involved in the study had to have a visual acuity of 20/40 or better in order to qualify.

The article explained the method by which the investigation proceeded. The participants, all 109 patients with DME, were assigned randomly to receive either focal photocoagulation, a 20 mg anterior sub Tenon injection of triamcinolone, a 20 mg anterior sub Tenon injection followed by focal photocoagulation after 4 weeks, a 40 mg posterior sub Tenon injection of triamcinolone or a 40 mg posterior sub Tenon injection followed by focal photocoagulation after 4 weeks. Of all the particpipants in the study, 38 patients received focal photocoagulation. There were 23 patients who had a 20 mg anterior sub Tenon injection of triamcinolone. There were also 25 of the participants who had a 20 mg anterior sub Tenon injection followed by focal photocoagulation after 4 weeks. There are 21 people who had a 40 mg posterior sub Tenon injection of triamcinolone. Lastly there were 22 who had 40 mg posterior sub Tenon injection followed by focal photocoagulation after 4 weeks.

In order to measure the changes in visual acuity and retinal thickness, the results were measured with optical coherence tomography or OCT with the aid of medical microscope. The article tells that at baseline, mean visual acuity in the study eyes was 20/25 and mean OCT central subfield thickness was 328 mums. The article further relates that the changes in retinal thickening and in visual acuity of the patient’s eyes were not significantly different among the 5 groups at 34 weeks. It was likewise stressed in the article that there was a suggestion of a greater proportion of eyes having a central subfield thickness less than 250 mum at 17 weeks when the peribulbar triamcinolone was combined with focal photocoagulation.

The article reports that cases like elevated intraocular pressure and ptosis, or eyelid drooping, were commonly the adverse effects attributable to the injections. The article concludes that in DME cases with good visual acuity, peribulbar triamcinolone, with or without focal photocoagulation, is not benefitial. Based on these results, a phase III trial to evaluate the benefit of these treatments for cases of mild DME is not warranted.Red more