Efficacy and safety of intravitreal triamcinolone acetonide in the management of recalcitrant diabetic macular edema

Background: Diabetic macular edema (DME) is the major cause of visual impairment among patients with diabetic retinopathy. The various treatment modalities available for DME are laser photocoagulation, intravitreal injection of anti-vascular endothelial growth factor drugs, and ocular corticosteroids. Usage of intravitreal injections of triamcinolone acetonide has shown to improve vision by reducing macular thickness and the benefits persisted for a longer duration. Aim: The aim is to evaluate the efficacy and safety of intravitreal triamcinolone acetonide in the management of recalcitrant DME. Methodology: A prospective interventional study was performed for 2 years among patients with DME at a tertiary care institute in Tamil Nadu. A total of 35 patients satisfying our inclusion and exclusion criteria were included in the study. Intravitreal injection of 0.05 ml (2 mg) of triamcinolone acetonide was given to all our study participants. The two major outcome parameters were best-corrected visual acuity (VA) and the central foveal thickness (CFT). Patients were followed up for 6 months. Results: Best-corrected visual acuity showed a statistically significant improvement till the end of 3 months, whereas the values measured at the end of 6 months showed no statistically significant difference. The reduction of values in CFT was found to be statistically significant both at the end of 3 months as well as at the end of 6 months. Conclusion: Intravitreal triamcinolone injection showed a significant improvement in VA and a reduction in CFT without an increase in intraocular pressure and in the incidence of cataracts.