Clinical Ophthalmology (Jul 2024)
Effectiveness of Suprachoroidal Injection of Triamcinolone Acetonide in Diabetic Macular Edema Following Pars Plana Vitrectomy Using a Modified Custom Microneedle
Abstract
Amin E Nawar, Ahmed Yousef Amin Ali, Omar Mohamed Massoud, Ahmed Roshdy Alagorie Ophthalmology Department, Faculty of Medicine, Tanta University, Tanta, EgyptCorrespondence: Amin E Nawar, Ophthalmology Department, Faculty of Medicine, Tanta University, Tanta, 31516, Egypt, Tel +2-01140095692, Email [email protected]: The present study evaluated the efficacy of suprachoroidal injection of Triamcinolone Acetonide (SCTA) in diabetic macular edema (DME) following pars plana vitrectomy (PPV) using a modified microneedle.Patients and methods: A prospective interventional study was conducted on 60 eyes of 60 patients with centrally involved diabetic macular edema following pars plana vitrectomy (PPV). SCTA was performed at the baseline and repeated after 3 months in case of persistent subretinal or intraretinal fluid, central macular thickness (CMT) more than 300 μm or visual loss by more than one line of the Snellen chart.Results: The present study detected significant reduction of the CMT from 498.3 ± 94.8 μm at the baseline to 212.3 ± 11.9 μm after 12 months of injection with p < 0.001 and a significant improvement of best corrected visual acuity (BCVA) from 1 (0.9– 1.2) at the baseline to 0.5 (0.3– 0.7) after 12 months of injection with p < 0.001. The intraocular pressure (IOP) increased significantly after 3 months of injection with p < 0.001 and then gradually declined to its normal level after 6 months. Inner segment/outer segment (IS/OS) disruption was the only significant predictor of the final CMT; however, the number of injections, IS/OS disruption, baseline BCVA and the HbA1C level were the significant predictors of the final BCVA after injection.Conclusion: Suprachoroidal injection of TA using this microneedle resulted in significant anatomical and functional improvement in previously vitrectomized diabetic macular edema patients with no recorded ocular or systemic adverse events.Keywords: suprachoroidal injection, triamcinolone acetonide, diabetic macular edema, pars plana vitrectomy
