Laser photocoagulation combined with subtenon injection of triamcinolone acetonide for diabetic cystoid macular edema.

BACKGROUND To compare the effects of laser photocoagulation combined with subtenon injection of triamcinolone acetonide with photocoagulation alone, for diabetic cystoid macular edema. METHODS This retrospective comparative study analyzed data for 34 eyes with cystoid macular edema treated with photocoagulation alone (n=17) or combined with triamcinolone (n=17). All patients were followed for 6 months after the procedure. Laser photocoagulation included focal photocoagulation focused on microaneurysms and light grid photocoagulation spread over the edematous retina. Subtenon injection of triamcinolone (20 mg/0.5 cc) was performed in the superior-temporal conjunctiva. RESULTS In the photocoagulation only group, the pretreatment mean visual acuity (VA) measured by the logarithm of the minimum angle of resolution (LogMAR) was 1.06+/-0.49. The number of laser spots was 34+/-10. The 6 -month post- treatment mean LogMAR was 1.13+/-0.60. In the photocoagulation combined with triamcinolone group, the pretreatment mean LogMAR was 1.31+/-0.49. The number of laser spots was 42+/-14. The 6 -month post- treatment mean LogMAR was 1.26+/-0.49. In the photocoagulation only group, 7 eyes had stable vision (improved, stable or loss of <2 lines) and 8 eyes had vision loss (loss>or=2 lines). In the photocoagulation combined with triamcinolone group, 15 eyes had stable vision and 2 eyes had vision loss. Fewer eyes had vision loss in the photocoagulation combined with triamcinolone group. (chi-square test, p=0.024). CONCLUSIONS This study, with a follow-up of 6 months, suggests that subtenon injection of triamcinolone combined with macular photocoagulation provides a better chance of stabilizing vision loss in patients with diabetic cystoid macular edema than photocoagulation alone.