Combined Effect of Intravitreal Triamcinolone Acetonide Injection with Panretinal Laser Photocoagulation on Concomitant Diabetic Macular Edema and Proliferate Diabetic Retinopathy

Diabetic retinopathy and macular edema are the most important cause of severe visual loss. At this study we evaluated the effectiveness of combined Intra Vitreal Triamcinolone Acetonide with panretinal laser photocoagulation on concomitant diabetic macular edema and high risk proliferate diabetic retinopathy. In a non randomized clinical trial, between Aug 2005 to Aug 2006 on 50 diabetic patients with advanced proliferative diabetic retinopathy and CSME were entered. Group 1 received Panretinal Photocoagulation and Macular Photocoagulation and Intra Vitreal Triamcinolone Acetonide (4mg) (right eye) and group 2 received only Panretinal Photocoagulation and Macular Photocoagulation (Left eye). Complete ophthalmologic examination, fluorescein angiography and optical coherence tomography (OCT) were performed before intervention and 2, 6 and 9-12 month after intervention in each groups. Two months after intervention Mean BCVA in group 1 was 0.35 0.33 and in group 2 was 0.47 0.28, (P=0.137). Mean centeral forveal thichness after 2, 6 and 9-12 months between two groups were as the following (257.38 73.91 P<0005 vs 341.81 110.380), (280.41 120.54 P<0005 vs 377.86 119.63) and (311.19 97.47 P=0.043 vs 369.62 123.53). Combination of intra vitreal triamcinolone acetonide injection with panretinal laser photocoagulation may be effective treatment on concomitant diabetic macular edema and proliferative diabetic retinopathy.