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Intravitreal triamcinolone prior to laser treatment of diabetic macular edema: 24-month results of a randomized controlled trial.

Publication ,  Journal Article
Gillies, MC; McAllister, IL; Zhu, M; Wong, W; Louis, D; Arnold, JJ; Wong, TY
Published in: Ophthalmology
May 2011

PURPOSE: To report the 24 months outcomes from a clinical trial of intravitreal triamcinolone acetonide (IVTA) plus laser versus laser treatment only in eyes with diabetic macular edema (DME). DESIGN: Prospective, double-masked, randomized, placebo-controlled study. PARTICIPANTS: Eighty-four eyes of 54 participants were entered into the study, with 42 eyes randomly assigned to receive IVTA plus laser and 42 randomly assigned to receive laser treatment alone. Primary end point data were available for 71 (84.5%) eyes at 24 months, with last visual acuity observation carried forward for the remaining eyes. METHODS: Best-corrected logarithm of minimum angle of resolution (logMAR) visual acuity and central macular thickness (CMT) by optical coherence tomography were measured after laser treatment preceded by either IVTA or sham. MAIN OUTCOMES MEASURES: The primary outcome was the proportion of eyes with improvement in visual acuity of 10 letters or more at 24 months. The secondary outcomes were mean visual acuity, requirement for further treatment, change in CMT, and adverse events. RESULTS: At 24 months, improvement of 10 logMAR letters or more was seen in 15 (36%) of 42 eyes treated with IVTA plus laser compared with 7 (17%) of 42 eyes treated with laser only (P = 0.047; odds ratio, 2.79; 95% confidence interval, 1.01-7.67). There was no difference in the mean CMT or mean logMAR visual acuity between 2 groups. At least 1 retreatment was required in the second year of the study in 29 (69%) of 42 IVTA plus laser-treated eyes compared with 19 (45%) of 42 laser only eyes (P = 0.187). Cataracts were removed from 17 (61%) of 28 phakic IVTA plus laser-treated eyes versus 0 (0%) of 27 laser only eyes (P<0.001). Treatment for elevated intraocular pressure was required in 27 (64%) of 42 IVTA plus laser eyes compared with 10 (24%) of 42 laser only eyes (P<0.001). CONCLUSIONS: Treatment with IVTA plus laser resulted in a doubling of improvement in vision by 10 letters or more compared with laser only over 2 years in eyes with DME, but is associated with cataract and raised intraocular pressure.

Duke Scholars

Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

May 2011

Volume

118

Issue

5

Start / End Page

866 / 872

Location

United States

Related Subject Headings

  • Visual Acuity
  • Triamcinolone Acetonide
  • Treatment Outcome
  • Tomography, Optical Coherence
  • Retina
  • Prospective Studies
  • Ophthalmology & Optometry
  • Male
  • Macular Edema
  • Laser Coagulation
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Gillies, M. C., McAllister, I. L., Zhu, M., Wong, W., Louis, D., Arnold, J. J., & Wong, T. Y. (2011). Intravitreal triamcinolone prior to laser treatment of diabetic macular edema: 24-month results of a randomized controlled trial. Ophthalmology, 118(5), 866–872. https://doi.org/10.1016/j.ophtha.2010.09.029
Gillies, Mark C., Ian L. McAllister, Meidong Zhu, Wanling Wong, Damien Louis, Jennifer J. Arnold, and Tien Y. Wong. “Intravitreal triamcinolone prior to laser treatment of diabetic macular edema: 24-month results of a randomized controlled trial.Ophthalmology 118, no. 5 (May 2011): 866–72. https://doi.org/10.1016/j.ophtha.2010.09.029.
Gillies MC, McAllister IL, Zhu M, Wong W, Louis D, Arnold JJ, et al. Intravitreal triamcinolone prior to laser treatment of diabetic macular edema: 24-month results of a randomized controlled trial. Ophthalmology. 2011 May;118(5):866–72.
Gillies, Mark C., et al. “Intravitreal triamcinolone prior to laser treatment of diabetic macular edema: 24-month results of a randomized controlled trial.Ophthalmology, vol. 118, no. 5, May 2011, pp. 866–72. Pubmed, doi:10.1016/j.ophtha.2010.09.029.
Gillies MC, McAllister IL, Zhu M, Wong W, Louis D, Arnold JJ, Wong TY. Intravitreal triamcinolone prior to laser treatment of diabetic macular edema: 24-month results of a randomized controlled trial. Ophthalmology. 2011 May;118(5):866–872.
Journal cover image

Published In

Ophthalmology

DOI

EISSN

1549-4713

Publication Date

May 2011

Volume

118

Issue

5

Start / End Page

866 / 872

Location

United States

Related Subject Headings

  • Visual Acuity
  • Triamcinolone Acetonide
  • Treatment Outcome
  • Tomography, Optical Coherence
  • Retina
  • Prospective Studies
  • Ophthalmology & Optometry
  • Male
  • Macular Edema
  • Laser Coagulation