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High-dose steroid slows diabetic retinopathy progression, but risk of adverse outcomes limits utility
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KOLOA, Hawaii — High-dose intravitreal steroid reduces the risk of progression of retinopathy secondary to diabetes when compared with photocoagulation, but the associated risk of adverse events outweighs potential benefit, according to a speaker here.
 Michael S. Ip |
An exploratory analysis of data from the recent DRCR.net 3-year comparison of 1-mg or 4-mg intravitreal triamcinolone vs. photo/grid photocoagulation showed a statistically significant lower rate of retinopathy progression — defined as any change on the ETDRS severity scale — among patients in the 4-mg group at 1, 2 and 3 years, Michael S. Ip, MD, said at Retina 2010.
The difference between photocoagulation and 1-mg triamcinolone was not statistically significant at any time point. The difference between 4-mg and 1-mg was significant at 2 years and borderline insignificant at 1 and 3 years. Cumulative probability of progression was 30%, 35% and 37% in the 4-mg, 1-mg and photocoagulation groups, respectively.
However, as previously reported in an analysis of the study's primary endpoint - visual acuity change - rates of cataract formation and IOP elevation were significantly higher in both steroid groups, with an even greater risk at the higher dose, Dr. Ip said.
Hawaiian Eye and Retina 2011 will be held January 16-21, 2011 at the Hyatt Regency Maui Resort & Spa in Ka'anapali, Maui. Learn more at OSNHawaiianEye.com.