Sivasubramanyam, M (2016) Comparison of the Efficacy and Safety of Single Dose of 4mg Vs 2mg Intravitreal Triamcinolone Acetonide Injection for Diabetic Cystoid Macular Edema. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION: Macular edema is an abnormal thickening of macula due to accumulation of fluid in extracellular spaces of the retina. It can occur due to circulatory disturbances and inflammatory conditions. Cystoid macular edema is accumulation of fluid in cyst like spaces in macula evident on clinical examination, fundus fluorescein angiography or optical coherence tomography. Diabetic macular edema is a microvascular complication of diabetes mellitus. It is one of the leading causes of vision loss in patients with diabetic retinopathy. Laser photocoagulation has been the standard treatment of diabetic macular edema. But in cases of long standing macular edema fluid tends to accumulate in cyst like spaces i.e. cystoid macular edema which can cause permanent visual loss. It is usually refractory to laser photocoagulation treatment. Intravitreal Triamcinolone Acetonide has been recently used to treat diabetic cystoid macular edema in cases refractory to laser photocoagulation treatment. It reduces microvascular leakage by its anti-inflammatory effects thereby reducing macular edema. The usual dosage used is 4 mg in 0.05 ml. The major adverse effects of this treatment had been the formation of cataract in phakic patients and intraocular pressure elevation. In this study we have compared the efficacy and safety of the usual 4mg dose vs 2mg dose. AIM OF THE STUDY: To Prospectively Compare the Efficacy of 4mg Vs 2mg Intravitreal Triamcinolone Acetonide Injection for Diabetic Cystoid Macular Edema. PRIMARY OBJECTIVE: To determine the dose with superior visual outcome. SECONDARY OBJECTIVE: To determine the dose with less complications with equivocal clinical benefits. STUDY DESIGN: Prospective Comparative Interventional study. METHODOLOGY: 50 patients with diabetic cystoid macular edema were selected and divided into two groups of 25 each. First group was treated with 4mg IVTA and second group was treated with 2 mg IVTA. All the patients were followed up with visual acuity assessment, central macular thickness assessment and intraocular pressure measurement at 4, 12 and 24 weeks. Results of both the groups were compared. CONCLUSIONS: Visual improvement is noted with both 4 mg and 2 mg Intravitreal Triamcinolone Acetonide though it is more pronounced and sustained with 4 mg dosage compared with 2 mg dosage. Both 4 mg and 2 mg Intravitreal Triamcinolone Acetonide are well tolerated over 6 month period with significant safety. But 4 mg dosage is associated with mild elevation of intraocular pressure in some patients unlike 2 mg dosage which appears to be more safer.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Diabetic Macular Edema ; Cystoid Macular Edema ; Intravitreal Triamcinolone Acetonide ; Central Macular Thickness. |
| Subjects: | MEDICAL > Ophthalmology |
| Depositing User: | Devi S |
| Date Deposited: | 29 Jan 2019 18:30 |
| Last Modified: | 29 Jan 2019 19:40 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/10428 |
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