Steroid therapy may provide stable, durable benefits to five years in patients with diabetic macular edema

Intravitreal steroid therapy proved durable out to five years in patients treated for vision loss secondary to diabetic macular edema and benefited patients who were initially treated with placebo in the first two years of a study.

After five years of therapy, patients who received intravitreal injections of triamcinolone acetonide for the duration of the study had a mean visual acuity of 61.0 logMAR compared with 59.0 logMAR at baseline and 64.4 logMAR at 2 years.

In patients treated initially with placebo, visual acuity was similar at baseline, mean 59.5 logMAR, and after two years, mean 59.0 logMAR. However, after being crossed over to triamcinolone, visual acuity improved to a mean 61.2 logMAR at five years.

Patients in the study also received adjunctive laser therapy at baseline when appropriate, and investigators were permitted to offer laser therapy during follow-up.

Patients initially treated with triamcinolone received more injections during years three to five (43 injections in 16 patients) compared with the initial-placebo group (26 injections in 13 patients), but the difference was not statistically significant.

Foveal thickness decreased by 30 µm less in the initial-triamcinolone group compared with the initial-placebo group from baseline to year five. From year two to year five, central macular thickness increased slightly in the initial-triamcinolone group but decreased in the initial-placebo group.

Gillies MC. Ophthalmology. 2009;116:2182-2187.