Retinal Vascular Caliber Changes after Intravitreal Triamcinolone Treatment for Diabetic Macular Edema
Sanj S Wickremasinghe 1,
Sophie Lousie Rogers 2,
Mark C. Gillies 3,
Meidong Zhu 4,
and
Tien Yin Wong 5*
1 Retina, Royal Victorian Eye & Ear Hospital, Melbourne, Victoria, Australia
2 Centre for Eye Research Australia, Department of Ophthalmology, University of Melbourne, East Melbourne, Victoria, Australia
3 Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
4 University of Sydney/Sydney Eye Hospital, Dept. of Clinical Ophthal & Save Sight Inst., Sydney, New South Wales, Australia
5 Department of Ophthalmology, University of Melbourne, 32 Gisborne Street, Melbourne, Victoria, 3002, Australia
* To whom correspondence should be addressed. E-mail: twong{at}unimelb.edu.au.
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Abstract |
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Purpose: To describe the changes in retinal vascular caliber in response to a single intravitreal triamcinolone injection in patients with refractory diabetic macular edema.
Design: Prospective data from a randomized clinical trial
Methods: The effects of intravitreal triamcinolone versus sham injections in patients with refractory diabetic macular edema were evaluated in a randomized clinical trial involving 69 eyes of 43 patients. Of these, 28 eyes (15 intravitreal triamcinolone and 13 sham) of 21 patients had gradable retinal photographs at the baseline and 3 month follow-up visit for analysis in the current study. Retinal vascular caliber was measured from digital fundus photographs and summarised as central retinal artery (CRAE) and vein (CRVE) equivalents in all eyes at baseline and at the 3 month follow-up visit.
Results: Over the 3 months of the study, there was a significant reduction compared to baseline in retinal arteriolar (147.8µm vs. 140.0 µm, p=0.047) and venular (219.5 µm vs. 198 µm, p= 0.039) caliber in eyes treated with intravitreal triamcinolone. There was no change in retinal arteriolar (139.9µm vs. 139.2µm, p=0.878) or venular (220.3µm vs. 217.6µm, p=0.534) caliber in those treated with sham injections.
Conclusion: Intravitreal triamcinolone has a significant narrowing effect on both retinal arteriolar and venular diameter in eyes with diabetic macular edema.
Key Words:
corticosteroids, diabetic retinopathy, macular edema
