Comparison between Suprachoroidal Triamcinolone and Intravitreal Triamcinolone Acetonide in patients of resistant Diabetic Macular Edema

Purpose:  To compare the effectiveness and safety of suprachoroidal versus intravitreal Triamcinolone Acetonide in cases of resistant diabetic macular edema. Study Design:  Quasi experimental study. Place and Duration of Study:  This research was executed at Retina Department of Al-Ibrahim Eye Hospital, Karachi, Pakistan between 1st January 2022 till 30th June 2022. Methods:  Thirty-four patients with resistant diabetic macular edema were selected through convenient sampling and divided equally into two groups. All patients underwent ocular examination. Group I was given single Intravitreal injection (IVI) of 0.1 mL Triamcinolone Acetonide at 4 mg per 0.1 mL concentration. Group II received same dosage of drug via Suprachoroidal injection (SCI). After 24 hours, they were assessed for side effects. After 6 weeks, second dose of same drug was administered. Patients were followed at 3 and 6 months. Results:  No serious side effect was observed in any patient within 24 hours. At 1 month follow-up period, comparison between the two groups for BCVA, CMT and IOP was not significant (p > 0.05). When the two groups were compared at 3 months, both routes were equally effective but IOP remained more stable via SCI route. At 6 months, IOP remained elevated in group I but decreased in group II (p = 0.003). Conclusion:  Triamcinolone Acetonide was effective by both routes in resistant diabetic macular edema in terms of improved BCVA and CMT but SCI was better in terms of IOP and cataract progression.