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Effects of posterior sub-Tenon?s capsule triamcinolone acetonide injection combined with microaneurysm photocoagulation on diffuse diabetic macular edema

Session Details

Session Title: Vascular Diseases III

Session Date/Time: Sunday 29/09/2013 | 08:00-10:00

Paper Time: 09:12

Venue: Hall 3 (Level 0)

First Author: S.Nonomura JAPAN

Co Author(s):    T. Oshitari   M. Arai   Y. Takatsuna   E. Sato     

Abstract Details

Purpose:

To compare the effects of posterior sub-Tenon’s capsule triamcinolone acetonide injection (STTA) alone to that of STTA combined with microaneurysm photocoagulation (MAPC) on eyes with diffuse DME.

Setting:

Department of Ophthalmology, Chiba University Hospital, Japan.

Methods:

The medical records of 138 eyes of 138 patients with diffuse DME treated with 20 mg of STTA alone or with 20 mg STTA combined with MAPC were reviewed. The diffuse DME were classified by their optical coherence tomographic (OCT) features: those with cystoid macular edema (CME; 100 eyes) and those with serous retinal detachment (SRD; 38 eyes). In the CME group, 61 eyes underwent STTA alone and the other 39 eyes underwent STTA combined with MAPC. In the SRD group, 22 eyes underwent STTA alone, and the other 16 eyes underwent STTA combined with MAPC. The central macular thickness (CMT) measured by OCT and best-corrected visual acuity (BCVA) were measured periodically for 6 months after the treatment. Statistical analyses were performed with paired t tests, Mann-Whitney U-tests, and repeated measure ANOVA.

Results:

Before treatment, the BCVA in the CME group was not significantly different from that in the SRD group. The BCVA was not significantly improved in both the CME group and the SRD group 6 months after treatment with STTA alone. The BCVA in the SRD group was not significantly improved 6 months after treatment with STTA combined with MAPC but was significantly improved in the CME group 6 months after treatment with STTA combined with MAPC (P=0.0473; paired t test). There was no significant difference in the BCVA between the CME group and SRD group 6 months after treatment with STTA alone or with STTA combined with MAPC. The CRT was significantly improved in both the CME and SRD groups after STTA alone (P<0.0001, P=0.0064, respectively; paired t tests) and after STTA combined with MAPC (P<0.0001, P=0.0415, respectively; paired t tests). There was no significant difference in the CRT between CME group and SRD group before both STTA and STTA combined with MAPC treatments. However, the CRT in the CME group was reduced significantly more than in the SRD group 6 months after treatment with STTA alone and with STTA combined with MAPC (P<0.0001, P<0.0001, respectively; repeated measure ANOVA).

Conclusions:

Our findings indicate that a combination of STTA with MAPC is more effective in resolving diffuse DME. In the CME type, the CRT was improved after STTA and STTA with MAPC significantly more than in the SRD type.

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