Hasan Ali TUFAN, Şengül ÖZDEK, Berati HASANREİSOĞLU

Comparison of intravitreal triamcinolone treatment and intravitreal triamcinolone with grid laser treatment in patients with diffuse diabetic macular edema

Amaç: Diffüz diabetik maküla ödeminde (DMÖ), intravitreal triamsinolon asetonid (İVTA) ve İVTA’ya ek maküler lazer grid fotokoagülasyon tedavisinin etkinliğini karşılaştırmak. Materyal-Metod: Diffüz DME mevcut 16 hasta retrospektif olarak değerlendirildi. Hastalar iki gruba ayrıldı: kontrol grubu (İVTA enjeksiyonu) ve lazer grubu (İVTA artı grid lazer). Tedavinin 3. ve 6. ayındaki en iyi düzeltilmiş görme keskinliği (DGK) ve santral maküler kalınlık (SMK) değerlendirildi. Aynı zamanda İVTA ile ilişkili komplikasyonlar ve tekrarlayan enjeksiyon gereksinimi değerlendirildi. Sonuçlar: Çalışmamızda 16 hastanın 18 gözü değerlendirilmiştir. Başlangıç DGK ve SMK sırasıyla kontrol grubunda 0.93±0.45 ve 530±136µm ve lazer grubunda 1.02±0.52 and 509±177µm idi. Tedavi sonrası DGK, 3. ve 6. ayda sırasıyla kontrol grubunda 0.73±0.4 and 0.75±0.45 ve lazer grubunda 0.98±0.44 and 1.04±0.4 idi (tüm değerler için p˃0.05). 3. ve 6. ayda SMK değerleri, kontrol grubunda 260±174µm (p=0.008) ve 362±163µm (p=0.05) ve lazer grubunda 331±161µm (p=0.05) ve 388±215µm (p˃0.05) idi. Kontrol grubunun %55’inde ve lazer grubunun %66’sında ilk enjeksiyondan ortalama 7±4 ay sonra ek enjeksiyon gerekmiştir. %22 katarakt gelişimi ve %33 göziçi basınç artışı izlendi. Tartışma: Diffüz diabetik maküla ödeminde İVTA enjeksiyonu sonrası uygulanan maküler grid lazer fotokoagülsayonun ek faydasının olmadığı izlenmiştir.

Diffüz diabetik maküler ödemli hastalarda intravitreal triamsinolon tedavisi ile intravitreal triamsinolon ve grid lazer tedavisinin karşılaştırılması

Objective: To compare the efficacy of intravitreal triamcinolone acetonide (IVTA) and IVTA plus macular laser grid photocoagulation therapy in diffuse diabetic macular edema (DME). Material and Methods: Sixteen patients affected by diffuse DME were retrospectively evaulated. Patients were divided into two groups: control group (IVTA injection) and laser group (IVTA plus grid laser). Main outcomes were best corrected visual aquity (BCVA) and central macular thickness (CMT) at the 3rd and 6th months of treatment. IVTA associated complications and reinjection necessity were assessed. Results: Our study comprised 18 eyes of 16 patients. The baseline BCVA and CMT were 0.93±0.45 and 530±136μm for the control and 1.02±0.52 and 509±177μm for the laser group respectively. Posttreatment BCVA at the 3rd and 6th month were 0.73±0.4 and 0.75±0.45 for control and 0.98±0.44 and 1.04±0.4 for laser group respectively (p>0.05 for all). CMT values at the 3rd and 6th months were 260±174μm (p=0.008) and 362±163 μm (p=0.05) for control and 331±161μm (p=0.05) and 388±215 μm (p>0.05) for laser groups. 55% of control and 66% of laser groups needed reinjection with an avarage of 7±4 months after the first injection. 22% cataract progression and 33% intraocular pressure elevation were noted. Conclusion: Macular grid laser photocoagulation after IVTA does not have beneficial effects for diffuse DME.

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