Intravitreal Injections of 4 mg and 20 mg Triamcinolone Acetonide in the Treatment of Diabetic Macular Edema: Comparison of Efficacy and Side Effects

Objectives: To compare the intravitreal injections of 4 mg/0.1mL and 20 mg/0.1 mL triamcinolone acetonide with respect to efficacy and side effects in the treatment of diabetic macular edema (DME). Materials and Methods: A total of 56 pseudophakic eyes of 56 patients with the diagnosis of DME were evaluated retrospectively. Twenty-eight eyes were randomly injected with 4 mg of intravitreal triamcinolone (IVTA) (group 1), while 28 eyes were applied 20 mg IVTA (group 2). The patients were evaluated before the injection and were followed up monthly for 6 months and in the 8th month afterwards. Best-corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure (IOP), and complication rates were determined and compared between the two groups. Results: When compared in terms of BCVA, there was a statistically significant increase in both groups (p<0.05). This increase lasted for 4 months in group 1, whereas it lasted for 6 months in group 2. Mean CMT decreased till the 4th month in group 1, while it lasted till the 5th month in group 2, and these findings were statistically significantly different (p<0.05). There was significant IOP spikes in both groups (p<0.05). Increase in IOP was observed till the 5th month, but a return to baseline values was determined in the 6th month. Conclusion: High-dose IVTA injections seem to have longer efficacy in terms of BCVA and CMT. However, studies which consist of larger groups of patients and longer follow-up period are needed for determining appropriate IVTA dosages in the treatment of DME.