SAN FRANCISCO -- November 3, 2009 -- Triamcinolone may be effective treatment option in patients with advanced diabetic macular oedema (DME) who have failed standard treatment fails, according to a study published in the November issue of the journal Ophthalmology.
The 5-year study based out of the University of Sydney, Sydney, Australia, found that intravitreal triamcinolone effectively improved vision in patients with DME whose eyes had continued to deteriorate despite receiving standard laser treatment.
"The majority of patients who improved with intravitreal triamcinolone after initial treatment continued to enjoy better vision at the 5-year conclusion of our clinical trial, and no new safety concerns were found in these patients," said lead researcher Mark Gillies, PhD, University of Sydney.
"We believe treatment with IVTA may be considered in carefully selected advanced DME patients when standard treatment has failed to improve vision," he added.
A total of 69 eyes (41 patients) were entered into the study, with 34 eyes initially receiving active treatment and 35 eyes receiving placebo. Five-year data were available for 44 of 67 eyes (66%). For the 23 eyes with missing 5-year data, of which 13 received placebo and 10 received IVTA, the last observation was carried forward.
Patients received an intravitreal injection of 0.1 ml of 40 mg/ml triamcinolone acetonide with adjunctive laser therapy where appropriate.
In the first 3 months after treatment, the patients initially treated with both intravitreal triamcinolone and laser showed significantly better gains in vision than control group patients, who were treated with laser only. After 2 years, patients in the original control group were also treated with intravitreal triamcinolone.
The beneficial effects persisted in most intravitreal triamcinolone-treated patients throughout the 5-year study; however, 80%t of patients in the initial intravitreal triamcinolone group developed elevated intraocular pressure and 56% required glaucoma therapy. Also, two-thirds of all patients required cataract surgery during the study period.
Similar outcomes have been noted in other studies of steroid-based treatment and thus were not considered new safety concerns by Dr. Gillies' group.
SOURCE: American Academy of Ophthalmology
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