The Effect of Macular Laser Photocoagulation on Visual Prognosis Before and After Intravitreal Triamcinolone Acetonide Injection in Diabetic Macular Edema

ABS TRACT Objective: To investigate the effect of macular laser photocoagulation (PC) on visual acuity (VA) before and after intravitreal triamcinolone acetonide (IVTA) injection in patients with diabetic macular edema (DME). Material and Methods: A hundred and thirty-four eyes that received single-dose IVTA 4 mg following DME diagnosis were divided into three groups: eyes with no PC (n=37), eyes that received PC before IVTA 8n=46) and eyes that received PC only after IVTA (n=51). Visual acuity values (LogMAR) were measured at start (before injection), 1. week, 1st, 3rd and 6th months, 1st and 2nd year for comparisons. Results: DME cases who received macular PC and then IVTA showed significant improvements in VA at 1st week (p=0.008) and 1st, 3rd, 6th months (p=0.001, p=0.002, p=0.001 respectively) when compared to pre-treatment value. Patients who received only IVTA showed significant VA improvement at 6th month (p=0.001). Patients who received IVTA and then macular laser PC in the first month showed similar VA results when compared to patients who received only IVTA. During the two years follow-up, 4% of all patients developed secondary glaucoma that was controlled by medication. Conclusion: In patients with DME, IVTA injection with or without macular laser PC provided significant improvement in VA of all eyes during six months. IVTA combined with macular laser PC treatment in the 1st month did not provide an additional benefit. However, we suggest that it may be useful for reducing VA loss at the end of two years.