Triamcinolone before panretinal photocoagulation may protect against visual loss, macular thickening

The data from this study suggest that a posterior sub-Tenon capsule injection of triamcinolone acetonide prior to panretinal photocoagulation (PRP) can help minimize PRP-induced visual loss by reducing macular thickening. Although more data is needed to demonstrate a clinical benefit, this finding could be the basis for a new standard of care for proliferative diabetic retinopathy (PDR). The authors randomized 41 patients with bilateral severe nonproliferative diabetic retinopathy or PDR to undergo a single, 20-mg injection of triamcinolone acetonide in one eye and no injection in the contralateral eye one week before PRP treatment.

PRP was performed four times at two-week intervals in both eyes of each patient. The number of spots per session was approximately 400. In cases with clinically significant macular edema at baseline, focal or laser grid therapy was performed at the first PRP session.

After six months, logMAR BCVA worsened in the control group by 0.010 and improved by 0.072 in the injection group, which was significantly different. Foveal thickness increased by 32.8 µm in the control group and lessened by 9.7 µm in the injection group, which was also significantly different.

The authors concluded that a single posterior sub-Tenon triamcinolone injection before PRP may prevent PRP-induced visual loss in eyes with diabetic retinopathy by reducing the chance of macular thickening.

Financial Disclosures
Dr.Haas has no financial interests to disclose.