Diabetik maküler ödemde subtenon triamsinolon ile kombine fokal lazer fotokoagülasyonun etkinliğinin değerlendirilmesi

Amaç: Bu çalışmanın amacı subtenon triamsinolon (ST) enjeksiyonu ile fokal lazer fotokoagülasyon kombinasyonunun diyabetik maküler ödem (DMÖ)’de etkinlik ve güvenilirliğinin araştırılmasıdır. Gereç ve yöntem: Diyabetik maküler ödem olan ve fokal lazer fotokoagülasyon ile birlikte 40 mg ST enjeksiyonu yapılan hastaların dosyaları retrospektif olarak değerlendirildi. On yedi hastanın 17 gözü çalışma kapsamına alındı. Tüm hastalara tedavi öncesi tam bir oftalmolojik muayene yapıldı. Tedavi sonrası 1. hafta, 1. ay ve daha sonra 3 aylık dönemlerde kontrole çağrıldı. Tedavinin etkinliği ST enjeksiyonundan sonraki 1. ay ve ardından 3 aylık dönemlerde görme keskinliği ve flöresein anjiyografi (FA) ile değerlendirildi. İstatistik analizde tekrarlı ölçümlerde ANOVA testi kullanıldı. Bulgular: Hastaların yaş ortalaması 61,5±8,7 yıl idi. Görme keskinliği enjeksiyon öncesi 0.22±0.13 iken 1. ayda 0.39±0.15, 3. ayda 0.36±0.18, 6. ayda 0.33±0.15 ve 12. ayda 0.34±0.16 oldu. Tüm takip muayenelerindeki ortalama görme keskinlikleri enjeksiyon öncesi ile karşılaştırıldığında aradaki fark anlamlı idi (p ˂0.05). Son muayenede görme keskinliği 13 (%76,4) hastada arttı, 3’ünde (%17,6) aynı kaldı ve 1’inde (%5,8) azaldı. Sonuç: Diyabetik maküler ödemi olan hastaların tedavisinde subtenon 40 mg triamsinolon enjeksiyonu ile fokal lazer fotokoagülasyon kombinasyonunun güvenli ve yararlı olduğu düşünüldü.

The evaluation of efficacy of subtenon triamcinolone injection combined with focal laser photocoagulation in diabetic macular edema

Objectives: The aim of this study was to investigate efficacy and safety of subtenon triamcinolone (ST) in combination with focal laser photocoagulation in diabetic macular edema (DME). Materials and methods: Medical records of patients with DME, treated with 40 mg subtenon injection of triamcinolone acetonid prior to focal laser photocoagulation were retrospectively analyzed. Seventeen eyes of 17 patients with DME were enrolled in the study. All patients underwent a comprehensive ophthalmological examination before the treatment. Efficacy of the treatment after ST injection was evaluated by visual acuity and flourescein angiography (FA). Follow-up visits were performed at 1st, 3rd, 6th and 12th months. Repeated measures ANOVA was used for statistical analysis. Results: The mean age was 61.5 ± 8.7 years and the mean visual acuity in the study eyes was 0.22 ± 0.13 before the treatment, 0.39 ± 0.15 at 1st month, 0.36 ± 0.18 at 3rd month, 0.33 ± 0.15 at 6th month and 0.34 ± 0.16 at 12th month. The differences in the visual acuity before the treatment and follow-up visits were significant (p ˂0.05). Visual acuity was increased in 13 (%76,4) patients, decreased in 1 (%5,8) and unchanged in 3 (%17,6). Conclusion: Injection of 40 mg of triamsinolon via subtenon route combined with focal laser photocoagulation is a safe and beneficial treatment in cases of DME

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