Effect of Posterior Subtenon Triamcinolone Acetonide in Refractory Diabetic Macular Edema

Muhammad Kashif Habib; Rubab Shafqat; Zeeshan Khan Oozeerkhan; Anwar Ahmed Gul; Nighat Jabeen; Muhammad Usman Sadiq

doi:10.51253/pafmj.v72i4.3597

Authors

Muhammad Kashif Habib Al Shifa Trust Eye Hospital, Rawalpindi Pakistan
Rubab Shafqat Riphah International University, Islamabad Pakistan
Zeeshan Khan Oozeerkhan Al Aleem Medical College, Lahore Pakistan
Anwar Ahmed Gul Pakistan Institute of Medical Sciences, Islamabad Pakistan
Nighat Jabeen Quetta Institute of Medical Sciences, Quetta Cantt Pakistan
Muhammad Usman Sadiq Mohi-ud-Din Islamic Medical College, Mirpur, Azad Jammu and Kashmir Pakistan

DOI:

https://doi.org/10.51253/pafmj.v72i4.3597

Keywords:

Central macular thickness, Intraocular pressure, Intravitreal bevacizumab, Posterior subtenon triamcinolone, Refractory diabetic macular edema

Abstract

Objectives: To see the effect of Posterior Subtenon Triamcinolone Acetonide (PSTT) injection in refractory Diabetic Macular Edema (DME).

Study Design: Quasi-Experimental Study.

Place and Duration of Study: Retina Clinic, Al-Shifa Trust Eye Hospital, Rawalpindi, from Jun to Dec 2018.
Methodology: Patients with Clinically Significant Macular Edema (CSME), with Central Macular Thickness (CMT) >300 microns and those who did not respond to three consecutive Intra-Vitreal Bevacizumab (IVB) injections were included. Posterior Subtenon Triamcinolone Acetonide (PSTT) was administered by a single retina fellow using the same protocol. Each patient’s best-corrected visual acuity (BCVA), Intra-ocular pressure (IOP) and Central Macular Thickness (CMT) were evaluated on the day of Posterior Subtenon Triamcinolone Acetonide (PSTT) injection and again at 1, 3 and 6 months.

Results: Out of 52 patients (104 eyes), 16 females and 36 males were present. The mean age was 57.67±9.35 years. Out of 52 right eyes, the mean Central Macular Thickness (CMT) at the first visit was 388.83±172.04 µm, 332.81 ± 144.69 µm after one month, 292.81±147.59µm after six months of Posterior Subtenon Triamcinolone Acetonide (PSTT) Injection. Similarly, for 52 left eyes mean Central Macular Thickness (CMT) at the first visit is 375.79±160.81 µm, 364.52 ± 167.95 µm after one month and 323.37±155.74 µm after six months. Similar results were observed for IOP and BCVA.

Conclusion: Posterior Subtenon Triamcinolone (PSTT) injections are effective in diabetic macular oedema, which does not respond to intravitreal anti-VEGF (IVB) therapy.