The effect of posterior subtenon methylprednisolone acetate in the refractory diabetic macular edema: a prospective nonrandomized interventional case seriesReport as inadecuate




The effect of posterior subtenon methylprednisolone acetate in the refractory diabetic macular edema: a prospective nonrandomized interventional case series - Download this document for free, or read online. Document in PDF available to download.

BMC Ophthalmology

, 6:15

First Online: 04 April 2006Received: 06 January 2006Accepted: 04 April 2006

Abstract

BackgroundTo investigate the efficacy of posterior subtenon methylprednisolone acetate injection in treatment of refractory diffuse clinically significant diabetic macular edema CSME.

MethodsIn a prospective, nonrandomized, interventional case series, 52 eyes were diagnosed with CSME and treated with at least two sessions of laser photocoagulation according to Early Treatment Diabetic Retinopathy Study guidelines. At least 3 months after laser therapy, eyes with a residual central macular thickness were offered posterior subtenon injection of 40 mg methylprednisolone acetate. Main outcome measures were visual acuity, macular thickness and intraocular pressure. Potential complications were monitored, including intraocular pressure response, cataract progression and scleral perforation.

ResultsMean baseline visual acuity in logMAR improved significantly p = 0.003 from 0.8 ± 0.36 to 0.6 ± 0.41 at 3 months. Mean foveal thickness decreased from 388 ± 78 μm at baseline to 231 ± 40 μm after 3 months p < 0.0001. Visual acuity improvement in eyes with CSME with extrafoveal hard exudates was significant p = 0.0001, but not significant in eyes with CSME with subfoveal hard exudates p = 0.32. Intraocular pressure increased from 14.7 ± 2.0 mmHg range, 12–18 mmHg to a maximum value of 15.9 ± 2.1 mmHg range, 12–20 mmHg during the follow-up period. Complications in two eyes developed focal conjunctival necrosis at the site of injection.

ConclusionPosterior subtenon methylprednisolone acetate may improve early visual outcome in diffuse diabetic macular edema that fails to respond to conventional laser photocoagulation. Visual acuity improvement in eyes with CSME with extrafoveal hard exudates was significant; and this improvement is depends on location of hard exudates. Further study is needed to assess the long-term efficacy, safety, and retreatment.

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Author: Alireza Javadzadeh

Source: https://link.springer.com/



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