Study of Structural Changes in Diabetic Macular Edema by Spectral Domain Optical Coherent Tomography after Intravitreal Injection of Triamcinolone Acetonide | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 9, Volume 71, Issue 4, April 2018, Page 2916-2925 PDF (864.48 K) | ||||
| Document Type: Original Article | ||||
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| Author | ||||
| Fatma AbdAlwahab Atwa, Zeinab Saad El-Din Elsanabary*, Mona Mohamad Aly Farag, Sahar Saad El-Deen Mohamed | ||||
| Ophthalmology Department, Faculty of Medicine (for Girls), Al-Azhar University, Cairo University* | ||||
| Abstract | ||||
| Purpose: is to study the morphological changes in Diabetic Macular Edema (DME) before and after intravitreal injection of triamcinolone acetonide using the spectral domain–optical coherence tomography (SD-OCT) parameters. Patient and methods: The study was held at Al-Zahraa University Hospital. It included 49 eyes of 40 patients with clinically significant diabetic macular edema (CSDME). A single intravitreal injection of triamcinolone acetonide (IVTA) at the dose of 4 mg in 0.1 ml was administered. Best corrected visual acuity (BCVA), intraocular pressure (IOP) and OCT scanning of the macula were done before and 3 months after IVTA. The OCT study parameters included central foveal thickness (CFT), OCT pattern of DME, vitreomacular interface (VMI), presence or absence of serous macular detachment (SMD), hard exudates (HEs), hyper-reflective spots (HRS) and IS/OS junction (Foveal ellipsoid zone) & ELM integrity. Results: Mean BCVA ± SD were (0.23 ± 0.13) and (0.39 ± 0.22) pre and 3 months after IVTA respectively. The initial mean CFT ± SD was (424 ± 127.1 um) while 3 months after IVTAit was (283.1 ± 70.2 um). Eighteen eyes showed SMD which was completely absent 3 months after a single IVTA. There was insignificant statistical difference of the VMI state before and 3 months after IVTA. Out of thirty-four eyes that showed the presence of HEs in this study, twenty-seven eyes showed diminution of these HEs size 3 months after injection. Forty-one eyes and forty-three eyes showed the presence of HRS before and after IVTA respectively. There was insignificant statistical difference in foveal ellipsoid zone and ELM integrity before and 3 months after IVTA. Complications were reported in 16 eyes (32.6%). Cataract progression was noted in 6 eyes (12.2 %). Steroid induced IOP elevation was reported in 10 eyes (20.4%). Conclusions: The data collected from OCT macular B scan are effective in the prognosis and follow up of diabetic macular edema. IVTA remains a promising primary therapy for DME at least in short terms. It seems relatively safe, but not without complications. | ||||
| Keywords | ||||
| Spectral Domain Optical Coherence Tomography; Diabetic Macular Edema; Intravitreal triamcinolone; Central Foveal Thickness; Hard Exudates; Hyper-reflective spots | ||||
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