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• W2317557686 abstract "To compare the efficacy of an intravitreal injection to a posterior subtenon injection of triamcinolone acetonide for the treatment of diffuse diabetic macular edema.Sixty patients with diabetes mellitus presenting with diffuse diabetic macular edema were recruited for the study. In each patient, one eye received a 4.0 mg (0.1 mL) intravitreal (IVT) injection of TA and the other eye was treated with a 40 mg (1.0 mL) posterior subtenon (PST) injection of triamcinolone acetonide (TA). We measured the visual acuity, the intraocular pressure (IOP) and the thickness of the macula using optical coherence tomography (OCT) before treatment and at one, three and six months after treatment.Eyes treated with PST showed 1-3 lines of improvement in Snellen's acuity from their pre-injection baseline visual status. The eyes in the IVT group showed 1-3 lines of improvement in Snellen's acuity in 80% of the treated eyes, but 20% of the treated eyes did not display any benefit at the end of six months. The difference in acuity between an IVT injection and a PST injection at six months post-treatment was statistically significant (p<0.05). The macular thickness of the eyes treated with an IVT injection was significantly reduced after one (222.7±13.4 μm; p<0.001) and three months (228.1±10.6 μm; p<0.001) of treatment. The eyes treated with a PST injection displayed a slow response and a significant improvement in macular thickness that was observed only after three months (231.3±10.9 μm; p<0.001). The difference between the eyes treated with an IVT injection (385.2±11.3 μm) and those treated with a PST injection (235.4±8.7 μm) was significantly different six months after treatment (p<0.001). The IOP of the eyes treated with an IVT injection was significantly increased after one (17.7±1.1 mm/Hg; p<0.020), three (18.2±1.2 mm/Hg; p<0.003) and six months (18.1±1.320 mm/Hg; p<0.007) when compared to the baseline value (16.1±1.4 mm/Hg). The eyes treated with a PST injection displayed no significant increase in IOP after one (16.4±1.2 mm/Hg; p<0.450), three (16.3±1.1 mm/Hg; p<0.630) and six months (16.2±1.1 mm/Hg; p<0.720) when compared to the baseline value (16.2±1.3 mm/Hg).A PST injection is equally effective and safer than an IVT injection of TA for the management of diffuse DME.Diffüz diyabetik makula ödemi tedavisinde posterior subtenon ve intravitreal triamsinolon enjeksiyonunun etkinliğini karşılaştırmak.Diabeti olup diffüz diyabetik makula ödemi ile başvuran altmış hasta çalışmaya alındı. Her hastanın, bir gözüne 40 mg (1.0 mL) posterior subtenon (PST) triamsinolon (TA) enjeksiyonu ve diğer gözüne 4.0 mg (0.1 mL) intravitreal (IVT) TA enjeksiyonu uygulandı. Görme keskinliği, göz içi basıncı (GİB) ve optik koherans tomografi (OCT) ile makula kalınlığı tedavi öncesi ve tedavi sonrası bir, üç ve altıncı ayda kaydedildi.PST enjeksiyon ile tedavi edilen gözler enjeksiyon sonrası Snellen eşelinde 1–3 satır artış göstermiştir. IVT grubunda tedavi edilen gözlerin % 80’inde Snellen keskinliğinde 1–3 satır iyileşme gözlendi, ancak tedavi edilen gözlerin % 20’sinde altı ay sonunda herhangi bir yarar sağlanmamıştır. Altı ay tedavi sonrası IVT enjeksiyon ve PST enjeksiyon arasında görme keskinliği açısından istatistiksel olarak anlamlı (p<0.05) fark bulunmuştur. IVT enjeksiyon ile tedavi gözlerin maküla kalınlığı bir (222.7±13.4 mikron p<0.001) ve üçüncü aylardan (p<0.001 228.1±10.6 mikron) sonra önemli şekilde azalmıştır. PST enjeksiyon ile tedavi edilen gözler yavaş cevap gözlenmiştir ve maküla kalınlığında anlamlı (231.3±10.9 mikron, p<0.001) bir düşüş sadece üç ay sonra gözlenmiştir. IVT enjeksiyon (385.2±11.3 mikron) ile tedavi olan gözlerde ve PST enjeksiyon (235.4±8.7 mikron) ile tedavi olan gözler arasında arasında altıncı ayda maküler kalınlık açısından anlamlı bir fark (p<0.001) bulunmuştur. IVT enjeksiyonu ile tedavi edilen gözlerin GİB değeri başlangıç değerlerine (16.1±1.4 mm / Hg) göre birinci ay (17.7±1.1 mm / Hg p<0.020), üçüncü ay (18.2±1.2 mm / Hg, p<0.003) ve altıncı ayda (18.1±1.320 mm /Hg, p<0.007) anlamlı artış göstermiştir. PST enjeksiyonu ile tedavi edilen gözlerin GİB değeri başlangıç değerlerine(16.2 ±1.3 mm / Hg) göre birinci ay (16.4±1.2 mm / Hg p<0.450), üçüncü ay (16.3±1.1 mm / Hg, p<0,630) ve altıncı ayda (16.2±1.1 mm / Hg, p<0.720) anlamlı artış göstermiştir.TA’nın diffüz DME tedavisi için PST enjeksiyonu, IVT enjeksiyonu kadar etkili ve daha güvenlidir." @default.
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• W2317557686 date "2013-10-19" @default.
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• W2317557686 title "Comparison of the Efficacy Between an Intravitreal and a Posterior Subtenon Injection of Triamcinolone Acetonide for the Treatment of Diffuse Diabetic Macular Edema" @default.
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• W2317557686 doi "https://doi.org/10.5152/eajm.2013.38" @default.
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