A COMPARATIVE STUDY OF EFFECTS OF INTRAVITREAL TRIAMCINOLONE ACETONIDE INJECTIONS OF DIFFERENT DOSES IN PATIENTS WITH DIABETIC MACULAR EDEMA

Diabetic macular edema (DME) is a signicant cause of visual impairment in individuals with diabetes. This prospective, randomized, comparative study aimed to assess the visual outcomes and complications associated with different doses (1mg, 2mg, and 4mg) of Intravitreal Triamcinolone Acetonide (IVTA) injection in patients with DME. A total of 75 patients were enrolled, and following clinical diagnosis, they were randomly assigned to receive one of the three IVTA doses. Visual acuity, intraocular pressure (IOP), cataract progression, and macular edema reduction were evaluated at various time points post-injection. The study found that visual acuity improvement was comparable between the 1mg and 2mg groups, showing 52% and 56% improvement, respectively. The 4mg group exhibited a slightly lower improvement rate of 40%. Fluorescein angiogram (FFA) results indicated that 68% of patients in the 2mg group showed improvement, while it was 60% in the 1mg group and 64% in the 4mg group. Optical coherence tomography (OCT) revealed a mean reduction in macular thickness of 59.28 micrometers in the 1mg group, 97.08 micrometers in the 2mg group, and 91.68 micrometers in the 4mg group. However, the study also observed signicant complications associated with the higher 4mg dose. Patients in the 4mg group experienced a more pronounced rise in IOP, which peaked at the end of the rst month post IVTA. Fortunately, IOP levels returned to normal by the end of three months with the help of topical antiglaucoma medications. Additionally, cataract progression was more prominent in the 4mg group compared to the 1mg and 2mg groups. In conclusion, this study suggests that administering a 4mg dose of IVTA does not yield signicantly better outcomes than a 2mg dose in terms of DME improvement. On the contrary, the higher dose is associated with a higher risk of complications, including elevated IOP and accelerated cataract formation in phakic patients. Thus, a careful consideration of the dose is crucial when using IVTA to treat diabetic macular edema.