Intravitreal Triamcinolone Compared With Macular Laer Grid Photocoagulation for the Treatment of Cytoid Macular Edema

Purpoe To evaluate the outcome of cytoid macular edema (CME) treated with intravitreal injection of triamcinolone acetonide (TA), macular laer grid photocoagulation (MLG), or both (TA+MLG). Deign Propective, randomized, interventional, parallel, three-arm clinical trial. Method etting: Intitutional clinical tudy. patient: Fifty-ix patient (63 eye) affected by diabetic or retinal vein occluion CME. procedure: Twenty-two eye received intravitreal injection of 4 mg TA; 21 eye underwent MLG; and 20 eye received intravitreal injection of 4 mg TA, and after 3 month, MLG. main outcome meaure: Bet-corrected viual acuity (VA), central macular thickne (CMT) (by optical coherence tomography), and potoperative complication. Reult Mean follow-up wa 9 ± 2 month (range 6 to 12 month). Baeline VA (logarithm of minimal angle of reolution [logMAR]) and CMT were, repectively, 0.82 ± 0.19 and 556 ± 139 μm micron for the TA group, 0.84 ± 0.15 and 601 ± 102 μm micron for the MLG group, and 0.83 ± 0.22 and 573 ± 106 μm micron for the TA+MLG group (no tatitically ignificant difference among the group). After the treatment, at 45 day, 3, 6, and 9 month in the TA group, VA had improved (P = .004) by 0.26, 0.25, 0.22, and 0.23 logMAR and CMT had decreaed by 37%, 33%, 29%, and 31% (P = < .001). In the MLG group, VA wa unchanged although CMT had decreaed by 5%, 13%, 14%, and 16% (P = .021). In the TA+MLG group, VA had improved (P = .003) by 0.26, 0.24, 0.19, and 0.20 logMAR, and CMT had decreaed by 36%, 34%, 28%, and 29% (P = < .001). The group receiving triamcinolone had better VA and lower CMT value at all time point (P < .05). A reinjection wa performed in eight eye; intraocular preure increaed in nine eye (treated with medical therapy), and cataract progreed in one eye. No injection-related complication occurred. Concluion TA intravitreal injection improve VA and reduce CMT more than MLG, which in triamcinolone-treated eye doe not offer further advantage. Intravitreal TA injection could be ued a primary treatment in patient with CME.