Steroid therapy may provide stable, durable benefits to 5 years in diabetic macular edema patients

Ophthalmology. 2009;116(11):2182-2187.

Intravitreal steroid therapy proved durable out to 5 years in patients treated for vision loss secondary to diabetic macular edema and benefited patients who were initially treated with placebo in the first 2 years of a study.

After 5 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 2 years, mean 59.0 logMAR. However, after being crossed over to triamcinolone, visual acuity improved to a mean 61.2 logMAR at 5 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 3 to 5 (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 5. From year 2 to year 5, central macular thickness increased slightly in the initial-triamcinolone group but decreased in the initial-placebo group.