Purpose: To evaluate the efficacy of intravitreal triamcinolone injection in diabetic macular edema unresponsive to intravitreal bevacizumab.
Methods: Patients with diabetic macular edema unresponsive to at least three monthly intravitreal bevacizumabs were included. At least 2 months after the last intravitreal bevacizumab, intravitreal triamcinolone was performed after obtaining an aqueous humor sample. Multiplex cytokine array was used to assay vascular endothelial growth factor, interleukin (IL)-2, IL-6, IL-8, tumor necrosis factor-α, and transforming growth factor-β2. Best-corrected visual acuity and central subfield thickness were evaluated from Month 0 to 3.
Results: Twenty eyes were enrolled. The mean best-corrected visual acuity was 47.1 ± 18.9 letters at baseline, and significantly increased to 53.3 ± 19.7 letters at 1 month (P = 0.002) and 52.4 ± 19.1 letters at 2 months (P = 0.041). These visual gains were not sustained at 3 months (50.9 ± 18.6; P = 0.204). A decrease in central subfield thickness more than 11% of baseline occurred in 12 eyes at 1 month. Multivariate analysis showed that intraocular levels of IL-8 (β = 0.538 P = 0.006) was an independent factor for anatomic response at 1 month.
Conclusion: Intravitreal triamcinolone has a role in patients who are unresponsive to intravitreal bevacizumab over the short-term. Elevated intraocular IL-8 levels were related to the efficacy.
Intravitreal triamcinolone has beneficial effects in patients with diabetic macular edema who are unresponsive to bevacizumab and focal laser photocoagulation over the short-term.
*Catholic High-Performance Cell Therapy Center, College of Medicine, The Catholic University of Korea, Seoul, Korea;
†Department of Medical Life science, College of Medicine, The Catholic University of Korea, Seoul, Korea; and
‡Department of Ophthalmology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Reprint requests: Won Ki Lee, MD, PhD, Department of Ophthalmology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, #505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Korea; e-mail: firstname.lastname@example.org
None of the authors have any financial/conflicting interests to disclose.