Akademik Veri Yönetim Sistemi
5. EVRS, Örebro, İsveç, 18 - 22 Haziran 2005, ss.1, (Özet Bildiri)
The Effect of Intravitreal Triamcinolone Acetonide on Optic Nerve Head Topography
Yusuf Akar, Cemil Apaydin, Meryem Altin, Asli Oner
Purpose: To assess the effects of intravitreal triamcinolone acetonide injection on optic nerve head topography. Methods: The study population consisted of one eye of 23 patients with type 2 diabetes mellitus with clinically significant macular edema. None of the patients had proliferative diabetic retinopathy or a history of retinal laser photocoagulation. All eyes had received 4 mg of triamcinolone, injected into the vitreous cavity 3.5 mm posterior to the limbus. Fluorescein angiography was performed before and about 2 weeks after the injection. Snellen visual acuity and intraocular pressure (as determined with Goldmann applanation tonometry) were also measured before and after the injection. All treated eyes underwent optic nerve head topographic analysis once before injection (within 30 minutes), and repeated within 1 hour, 1 day, 1 week and 4 weeks after injection, respectively. Topographic analyses were performed using a confocal scanning laser ophthalmoscope, HRT-II. The disc area, topography standard deviation, and a total of 12 topographic parameters were calculated by HRT-II! Results: The mean age of the patients was 43.2 (SD 4.3) years. The mean disc area of the subjects was 2.47 (0.37) mm (2). Following injection, in the first hour, first day, and first and the second week, treated eyes demonstrated no significant change in the disc topography. However, four weeks following injection, the disc area, rim area, and the cup shape measure parameters were found to be decreased significantly (all p values <0.05). By the fourth week exam, visual acuity improved by at least 1 line in 18 eyes (78.3%) whereas visual acuity remained unchanged in the rest of the eyes (21.7%). Fluorescein angiography showed marked improvement of macular edema in 8 eyes (34.8%), mild improvement in 11 eyes (47.8%) and no change in 4 eyes (17.4%); no patient had worsening of macular edema. Conclusion: Although the number of patients in this pilot study was limited, present findings suggest that a single intravitreal injection of triamcinolone acetonide may lead to significant changes in some optic nerve head topographic parameters while it causes significant improvement in mean visual acuity and in clinical course of in the diabetic macular edema.