Intraocular Pressure: Intravitreal Preservative-free Triamcinolone Injection in Diabetic Macular Edema and Branch Retinal Vein Occlusion

Chan Ho Lee; Young Seung Seo

doi:10.3341/jkos.2020.61.2.167

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Lee and Seo: Intraocular Pressure: Intravitreal Preservative-free Triamcinolone Injection in Diabetic Macular Edema and Branch Retinal Vein Occlusion

Original Article

Journal of the Korean Ophthalmological Society 2020; 61(2): 167-174.

Published online: 18 February 2020

DOI: https://doi.org/10.3341/jkos.2020.61.2.167

Intraocular Pressure: Intravitreal Preservative-free Triamcinolone Injection in Diabetic Macular Edema and Branch Retinal Vein Occlusion

Chan Ho Lee, MD, Young Seung Seo, MD

Department of Ophthalmology, Dankook University College of Medicine, Cheonan, Korea.

Address reprint requests to Young Seung Seo, MD. Department of Ophthalmology, Dankook University Hospital, #201 Manghyang-ro, Dongnam-gu, Cheonan 31116, Korea. Tel: 82-41-550-6479, Fax: 82-41-561-0137, mailcarr@naver.com

Received 2 August 2019 Revised 19 September 2019 Accepted 17 January 2020

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the intraocular pressure (IOP) in diabetic macular edema (DME) patients and macular edema associated with branch retinal vein occlusion (BRVO) patients after intravitreal preservative-free Triamcinolone injection.

Methods

This study included 36 patients diagnosed with DME and 44 patients diagnosed with BRVO with macular edema. Both groups were treated with intravitreal preservative-free Triamcinolone (Maqaid®, Wakamoto Pharmaceutical Co., Ltd., Tokyo, Japan) injection, and we compared the IOPs of the two groups determined before injection and at 1, 2, 3, and 6 months after injection. We also compared the IOP elevation ratios and durations, and central foveal thickness (CFT) changes using optical coherence tomography.

Results

In both groups, there was no statistical significance in the IOP before injection and at 1, 2, 3, and 6 months after injection. However, the IOP elevation ratio in the DME patients (38.9%) was significantly higher than that in the BRVO patients (15.9%) (p = 0.02). The duration of IOP elevation in the DME patients (1.14 ± 1.85 months) was significantly longer than that in the BRVO patients (0.30 ± 1.20 months) (p = 0.03). When the IOP was not controlled, we used IOP-lowering agents, and two patients in the DME were treated with glaucoma surgery. There was no statistical significance in the CFT before injection and at 1, 2, or 3 months after injection between the two groups (p = 0.72, p = 0.26, p = 0.66, p = 0.34, respectively). However, the CFT after 6 months was 328 ± 103 µm in the DME group and 434 ± 189 µm in the BRVO; this difference was significant (p < 0.01).

Conclusions

Intravitreal injection of preservative-free Triamcinolone was effective in the treatment of both DME patients and macular edema patients associated with BRVO. Furthermore, Triamcinolone was more safely injected in macular edema associated with BRVO patients than in DME patients.

Keywords: Branch retinal vein occlusion, Central foveal thickness, Diabetic macular edema, Intraocular pressure, Preservative-free Triamcinolone

Figures and Tables

Table 1

Baseline characteristics of patients in DME group and BRVO group at this study

Values are presented as mean ± standard deviation or number.

DME = diabetic macular edema; BRVO = branch retinal vein occlusion.

^*t-test (p < 0.05).

Table 2

Between DME group and BRVO group, comparison of average IOP during 6 months after intravitreal preservative-free triamcinolone injection

Values are presented as mean ± standard deviation.

DME = diabetic macular edema; BRVO = branch retinal vein occlusion; IOP = intraocular pressure.

^*t-test (p < 0.05).

Table 3

Between DME group and BRVO group, comparison of average IOP elevated duration with all patients and IOP elevated patients, and difference about ratio of IOP elevation after intravitreal preservative-free triamcinolone injection (p < 0.05)

Values are presented as mean ± standard deviation or number (%).

DME = diabetic macular edema; BRVO = branch retinal vein occlusion; IOP = intraocular pressure.

^*χ² = 5.401; ^†chi-square test; ^‡t-test.

Table 4

Comparison of mean CFT after intravitreal preservative-free triamcinolone injection between DME group and BRVO group

Values are presented as mean ± standard deviation.

CFT = central macular thickness; DME = diabetic macular edema; BRVO = branch retinal vein occlusion.

^*t-test (p < 0.05).

Notes

^{Conflicts of Interest} The authors have no conflicts to disclose.

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