ROLE OF LASER PHOTOCOAGULATION VERSUS INTRAVITREAL TRIAMCINOLONE ACETONIDE IN ANGIOGRAPHIC MACULAR EDEMA IN DIABETES MELLITUS

Abstract

Aims: To compare the effect of laser photocoagulation and intravitreal triamcelone acetonide in the treatment of diabetic macular edema

Material and Methods: During the period of one year 100 patients having diabetic macular edema were enrolled in the project.Fluorescein angiography was carried out in all patients to confirm the diagnosis of macular edema. Patients were randomly assigned into two groups. One group was treated with laser photocoagulation and other group was given intravitreal triamcinolone.

Observations: 82 % of patients were of type 2 diabetes while 18 % had type 1 diabetes. 40 % patients had the disease for more than 15 years. 48 % patients had diffuse macular edema on fluorescein angiography. 38 % showed a focal pattern of edema and 14% showed a mixed pattern. At three months patients receiving triamcinolone had better visual acuity compared to laser photocoagulation. However these findings were reversed by 12 months and laser photocoagulation remained superior to triamcinolone at the end of 1 year of follow up.

Discussion: A similar study conducted by DRCR compared laser photocoagulation to intravitreal triamcinolone for treatment of diabetic macular edema. At four months, patients receiving intravitreal triamcinolone had better visual acuity compared to laser photocoagulation. These findings were reversed by 16 months, and laser photocoagulation remained superior to triamcinolone at three-year follow-up.

Conclusion: Our study showed that although intravitreal triamcinolone was successful in improving visual acuity in patients at the end of 3 months the effect was transient and in long term laser photocoagulation was more effective.