The Pan-American Journal of Ophthalmology (Jan 2023)
Optical coherence tomography biomarkers after intravitreal triamcinolone acetonide in patients with diabetic macular edema
Abstract
Background and Objective: Optical coherence tomography (OCT) plays a crucial role in guiding the treatment and establishing the prognosis of diabetic macular edema (DME). We aimed to determine which OCT biomarkers respond better to intravitreal triamcinolone acetonide (IVTA) switch after antivascular endothelial growth factor (anti-VEGF) treatment poor response. Materials and Methods: Fifty-eight eyes with DME, submitted to IVTA switch, were included in this retrospective study. OCT biomarkers and best-corrected visual acuity (VA) were assessed, before and after treatment with a mean follow-up of 2.9 months. Results: IVTA switch resulted in improved VA, central foveal thickness (CFT), and macular volume. Intraretinal cysts decreased or disappeared completely (P = 0.007) in 84.2% of the eyes, as well as the hyperreflective foci (P = 0.004) and the subretinal fluid (P = 0.02). Conclusion: We show that IVTA switch is an effective rescue therapy in anti-VEGF therapy refractory DME. OCT plays an important role in selecting the most appropriate treatment, namely between anti-VEGF and steroids.
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